Provider Demographics
NPI:1639498819
Name:HIGHER GROUND HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:HIGHER GROUND HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BRUNS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:724-272-2964
Mailing Address - Street 1:828 WELLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SEVEN FIELDS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-8028
Mailing Address - Country:US
Mailing Address - Phone:724-272-2964
Mailing Address - Fax:724-741-2035
Practice Address - Street 1:828 WELLINGTON DR
Practice Address - Street 2:
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-8028
Practice Address - Country:US
Practice Address - Phone:724-272-2964
Practice Address - Fax:724-741-2035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009042E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty