Provider Demographics
NPI:1417181900
Name:HEALTHY TO THE BONE
Entity Type:Organization
Organization Name:HEALTHY TO THE BONE
Other - Org Name:HEALTHY TO THE BONE IN-HOME THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:DEMOLLI
Authorized Official - Last Name:SHIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:727-460-1802
Mailing Address - Street 1:9668 105TH TER
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-4507
Mailing Address - Country:US
Mailing Address - Phone:727-397-1580
Mailing Address - Fax:
Practice Address - Street 1:9668 105TH TER
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-4507
Practice Address - Country:US
Practice Address - Phone:727-397-1580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy