Provider Demographics
NPI:1356627939
Name:MANE & TAILL THERAPEUTIC HORSEMANSHIP ACADEMY
Entity Type:Organization
Organization Name:MANE & TAILL THERAPEUTIC HORSEMANSHIP ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PATH INSTRUCTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:KAREN
Authorized Official - Last Name:IULO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-489-1774
Mailing Address - Street 1:147 COLONIAL BEACH RD
Mailing Address - Street 2:
Mailing Address - City:JARVISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27947
Mailing Address - Country:US
Mailing Address - Phone:252-489-1774
Mailing Address - Fax:
Practice Address - Street 1:147 COLONIAL BEACH RD
Practice Address - Street 2:
Practice Address - City:JARVISBURG
Practice Address - State:NC
Practice Address - Zip Code:27947-9704
Practice Address - Country:US
Practice Address - Phone:252-489-1774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty