Provider Demographics
NPI:1043793524
Name:THE HEALING PROJECT PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:THE HEALING PROJECT PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARY BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:805-895-1712
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:LOS OLIVOS
Mailing Address - State:CA
Mailing Address - Zip Code:93441-0959
Mailing Address - Country:US
Mailing Address - Phone:805-895-1712
Mailing Address - Fax:805-576-7961
Practice Address - Street 1:2028 VILLAGE LN # 206
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-3221
Practice Address - Country:US
Practice Address - Phone:805-686-4642
Practice Address - Fax:805-576-7961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty