Provider Demographics
NPI:1619344876
Name:HEALING TREE PHYSICAL THERAPY CENTER LLC
Entity Type:Organization
Organization Name:HEALING TREE PHYSICAL THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:DEIRDRE
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:340-626-3478
Mailing Address - Street 1:PO BOX 11733
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-4733
Mailing Address - Country:US
Mailing Address - Phone:340-693-5683
Mailing Address - Fax:340-693-5682
Practice Address - Street 1:4002 RAPHUNE HILL
Practice Address - Street 2:AL COHEN'S PLAZA
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-693-5683
Practice Address - Fax:340-693-5682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI26208100000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty