Provider Demographics
NPI:1770890493
Name:SYNERGY HEALING ARTS, INC
Entity type:Organization
Organization Name:SYNERGY HEALING ARTS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PT/GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:530-550-0400
Mailing Address - Street 1:11890 DONNER PASS RD STE 1
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-4996
Mailing Address - Country:US
Mailing Address - Phone:530-550-0400
Mailing Address - Fax:530-820-9667
Practice Address - Street 1:11890 DONNER PASS RD STE 1
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-4996
Practice Address - Country:US
Practice Address - Phone:530-550-0400
Practice Address - Fax:530-820-9667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18842225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty