Provider Demographics
NPI:1043956790
Name:CORNERSTONE PHYSICAL THERAPY AND WELLNESS, LLC
Entity type:Organization
Organization Name:CORNERSTONE PHYSICAL THERAPY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:580-817-0082
Mailing Address - Street 1:451 MORTON STREET
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:KS
Mailing Address - Zip Code:67950-1111
Mailing Address - Country:US
Mailing Address - Phone:620-697-4331
Mailing Address - Fax:620-697-4322
Practice Address - Street 1:451 MORTON ST # 1111
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:KS
Practice Address - Zip Code:67950-5015
Practice Address - Country:US
Practice Address - Phone:620-697-4331
Practice Address - Fax:620-697-4322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty