Organization
MAX WELL THERAPY LLC
Active
Parent organization
MAX WELL THERAPY LLC
Other names
Max Well Physical therapy
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAX WELL THERAPY LLC
Authorized official
JILL M MAXWELL PT (OWNER)
(952) 440-5906
Entity
Organization
Contact information
Practice address
14033 COMMERCE AVE NE, PRIOR LAKE, MN 55372-1438
(952) 440-5906
(952) 440-5907
Mailing address
14033 COMMERCE AVE NE, PRIOR LAKE, MN 55372-1438
(952) 440-5906
(952) 440-5907
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018K0MA
GROUP #
MN
01
—
1819187
AMERICAS PPO
MN
01
—
AETNA
7368023
MN
Enumeration date
05/18/2006
Last updated
09/13/2007
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