Organization
WILD PHYSICAL THERAPY AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOLLYE LEAS-MEDREK DPT (OWNER)
(812) 662-5033
Entity
Organization
Contact information
Practice address
545 PAWTUCKET AVE # LL04A, PAWTUCKET, RI 02860-6046
(812) 662-5033
Mailing address
555 N MAIN ST # 1439, PROVIDENCE, RI 02904-5722
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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