Provider Demographics
NPI:1619531308
Name:UNBRIDLED STRENGTH EQUINE THERAPY
Entity Type:Organization
Organization Name:UNBRIDLED STRENGTH EQUINE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/COO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:N
Authorized Official - Last Name:HOLLADAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, FNP-C
Authorized Official - Phone:765-413-6101
Mailing Address - Street 1:2821 S 325 W
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-6936
Mailing Address - Country:US
Mailing Address - Phone:765-413-6101
Mailing Address - Fax:
Practice Address - Street 1:2821 S 325 W
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-6936
Practice Address - Country:US
Practice Address - Phone:765-413-6101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-28
Last Update Date:2019-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251V00000XAgenciesVoluntary or CharitableGroup - Multi-Specialty
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty