Provider Demographics
NPI:1871393603
Name:EMPOWERED WOMENS HEALTH PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:EMPOWERED WOMENS HEALTH PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'FALLON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:858-382-4842
Mailing Address - Street 1:32040 CAMINO HERENCIA
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3837
Mailing Address - Country:US
Mailing Address - Phone:951-595-7102
Mailing Address - Fax:
Practice Address - Street 1:32040 CAMINO HERENCIA
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-3837
Practice Address - Country:US
Practice Address - Phone:951-595-7102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty