Innovation Therapy and Wellness, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT008984 Issued in GA

Legal business name

INNOVATION THERAPY AND WELLNESS, LLC

Doing business as

FYZICAL Therapy and Balance Centers

Practice address

118 Azalea Rd Ste 11
Baxley, GA 31513-9197

Phone

(912) 245-2855

NPI assigned

Jun 21, 2017

Organization subpart

Yes

Parent organization

FYZICAL THERAPY AND BALANCE CENTERSAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Glen Posey

Title

Owner

Phone

(912) 245-2855

Specialties & licenses 1

Addresses

Other names 1

• FYZICAL Therapy and Balance Centers Doing business as

Part of

Innovation Therapy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1770003840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 AZALEA RD STE 11",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315139197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 AZALEA RD STE 11",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315139197",
            "telephone_number": "912-245-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FYZICAL THERAPY AND BALANCE CENTERS",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "POSEY",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-245-2855"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FYZICAL Therapy and Balance Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cassandra M Hower
• Marshall Keavin Hulett, FNP-BC
• Carrie Hunter, MT-BC
• Lynsey Sellers Hutchinson, M.ED CCC-SLP
• Timothy Charles Hutchinson Jr., LPC
• Mattie Jackson
• Evelyn J Johnson, M.D.
• Jeremy Braxton Johnson, RD, LD
• Carlie R Jones, PA-C
• Carolyn J Jones, FNP-BC

• Physical Therapist in Baxley, GA
• Providers in Baxley, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.