Provider Demographics
NPI:1376038216
Name:HOLISTIC PHYSICAL THERAPY & YOGA HEALING INC.
Entity Type:Organization
Organization Name:HOLISTIC PHYSICAL THERAPY & YOGA HEALING INC.
Other - Org Name:PLUTA MOVEMENT THERAPEUTICS INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ULANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-787-2729
Mailing Address - Street 1:312 S CEDROS AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1942
Mailing Address - Country:US
Mailing Address - Phone:619-787-2729
Mailing Address - Fax:858-350-1017
Practice Address - Street 1:312 S CEDROS AVE STE 206
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1942
Practice Address - Country:US
Practice Address - Phone:619-787-2729
Practice Address - Fax:858-350-1017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-23
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPTA48333261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy