Organization
ADVANCED WELLNESS LOUISIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KRISTOPHER WILLIAM GRUNEWALD DPT (OWNER/PHYSICAL THERAPIST)
(225) 202-6124
Entity
Organization
Contact information
Practice address
9808 BLUEBONNET BLVD STE 201, BATON ROUGE, LA 70810-6442
(225) 202-6124
Mailing address
2023 N WOODCHASE CT, BATON ROUGE, LA 70808-4023
(225) 202-6124
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
07612
LA
Other
Enumeration date
08/28/2017
Last updated
09/08/2017
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