Provider Demographics
NPI:1386826667
Name:HOLISTIC THERAPEUTICS OF GAINESVILLE LLC
Entity Type:Organization
Organization Name:HOLISTIC THERAPEUTICS OF GAINESVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOENBORN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:352-359-5667
Mailing Address - Street 1:5200 W NEWBERRY RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-6104
Mailing Address - Country:US
Mailing Address - Phone:352-359-5667
Mailing Address - Fax:
Practice Address - Street 1:5200 W NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6104
Practice Address - Country:US
Practice Address - Phone:352-359-5667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8189261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy