Provider Demographics
NPI:1619075736
Name:HOLLISTIC PHYSICAL THERAPY CENTER
Entity Type:Organization
Organization Name:HOLLISTIC PHYSICAL THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAY-MING
Authorized Official - Middle Name:
Authorized Official - Last Name:OU
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:626-576-5757
Mailing Address - Street 1:801 W VALLEY BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-3250
Mailing Address - Country:US
Mailing Address - Phone:626-576-5757
Mailing Address - Fax:626-576-5760
Practice Address - Street 1:801 W VALLEY BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-3250
Practice Address - Country:US
Practice Address - Phone:626-576-5757
Practice Address - Fax:626-576-5760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty