Provider Demographics
NPI:1598195729
Name:EMBODY HEALING CENTER
Entity Type:Organization
Organization Name:EMBODY HEALING CENTER
Other - Org Name:PREMA BELLY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NARDI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:541-891-1423
Mailing Address - Street 1:258 A ST
Mailing Address - Street 2:SUITE17
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1947
Mailing Address - Country:US
Mailing Address - Phone:541-891-1423
Mailing Address - Fax:
Practice Address - Street 1:258 A ST
Practice Address - Street 2:SUITE17
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1947
Practice Address - Country:US
Practice Address - Phone:541-891-1423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2016-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6652225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty