Provider Demographics
NPI:1356794986
Name:EPIPHANY PARTNERS, PLLC
Entity type:Organization
Organization Name:EPIPHANY PARTNERS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:MULFINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:727-271-9156
Mailing Address - Street 1:3152 LITTLE RD
Mailing Address - Street 2:SUITE #181
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1864
Mailing Address - Country:US
Mailing Address - Phone:727-271-9156
Mailing Address - Fax:727-499-6988
Practice Address - Street 1:3152 LITTLE RD
Practice Address - Street 2:SUITE #181
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1864
Practice Address - Country:US
Practice Address - Phone:727-271-9156
Practice Address - Fax:727-499-6988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18909172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Multi-Specialty