| Pure Wellness, Inc. | |
|
14600 Sherman Way Ste 300 Van Nuys CA 91405-2272 | |
| (818) 781-7097 | |
| Not Available |
| Full Name | Pure Wellness, Inc. |
|---|---|
| Speciality | Physical Therapist |
| Location | 14600 Sherman Way Ste 300, Van Nuys, California |
| Authorized Official Name and Position | Jodi-ann Foster (PRESIDENT/ PHYSICAL THERAPIST) |
| Authorized Official Contact | 2137133465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Wellness, Inc. 5555 W 6th St # 2-105 Los Angeles CA 90036-3361 Ph: () - | Pure Wellness, Inc. 14600 Sherman Way Ste 300 Van Nuys CA 91405-2272 Ph: (818) 781-7097 |
| NPI Number | 1558022004 |
|---|---|
| Provider Enumeration Date | 01/06/2022 |
| Last Update Date | 01/06/2022 |
| Certification Date | 01/06/2022 |
| Medicare PECOS PAC ID | 9537552369 |
|---|---|
| Medicare Enrollment ID | O20220131001265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558022004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Jodi-ann N Foster |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1023332491 PECOS PAC ID: 6507007960 Enrollment ID: I20180814003715 |
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