Provider Demographics
NPI:1508503426
Name:HEAL AT HOME PT & WELLNESS
Entity Type:Organization
Organization Name:HEAL AT HOME PT & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:CAMERON
Authorized Official - Last Name:BOJDA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:484-988-0781
Mailing Address - Street 1:9237 EAGLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1739
Mailing Address - Country:US
Mailing Address - Phone:484-988-0781
Mailing Address - Fax:
Practice Address - Street 1:9237 EAGLEVIEW DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-1739
Practice Address - Country:US
Practice Address - Phone:484-988-0781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty