Provider Demographics
NPI:1528357019
Name:KRAVETS PHYSICAL THERAPY,INC.
Entity Type:Organization
Organization Name:KRAVETS PHYSICAL THERAPY,INC.
Other - Org Name:KINETICA PHYSICAL THERAPY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAVETS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:818-521-5265
Mailing Address - Street 1:5154 DEL MORENO DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2426
Mailing Address - Country:US
Mailing Address - Phone:818-521-5265
Mailing Address - Fax:818-704-3862
Practice Address - Street 1:17777 VENTURA BLVD # 103
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3717
Practice Address - Country:US
Practice Address - Phone:818-521-5265
Practice Address - Fax:818-704-3862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty