Provider Demographics
NPI:1831973031
Name:W.A.V.E. PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:W.A.V.E. PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, GCS, CEEAA
Authorized Official - Phone:973-517-3652
Mailing Address - Street 1:19697 MARIMAR CT
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-3500
Mailing Address - Country:US
Mailing Address - Phone:973-517-3652
Mailing Address - Fax:
Practice Address - Street 1:19697 MARIMAR CT
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-3500
Practice Address - Country:US
Practice Address - Phone:973-517-3652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty