Provider Demographics
NPI:1760275317
Name:WMS LLC
Entity type:Organization
Organization Name:WMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMER
Authorized Official - Middle Name:HAJJAJ
Authorized Official - Last Name:WAHLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:916-842-9928
Mailing Address - Street 1:9750 HORNED LARK WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-8127
Mailing Address - Country:US
Mailing Address - Phone:916-842-9928
Mailing Address - Fax:
Practice Address - Street 1:9750 HORNED LARK WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-8127
Practice Address - Country:US
Practice Address - Phone:916-842-9928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy