Provider Demographics
NPI:1518664010
Name:HEALING PULSE PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:HEALING PULSE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:312-810-2181
Mailing Address - Street 1:1613 S SPAULDING AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-3845
Mailing Address - Country:US
Mailing Address - Phone:312-810-2181
Mailing Address - Fax:
Practice Address - Street 1:122 LINCOLN BLVD STE 203
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-2859
Practice Address - Country:US
Practice Address - Phone:424-239-9227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty