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General NPI Number Information
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NPI Number | 1043665748
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Entity Type | Organization
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Legal Business Name | HEALING YOU THERAPY, PLLC
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Dates
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Enumeration Date | 04/30/2016
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Last Update Date | 04/30/2016
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Provider Practice Location Address
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Address Line | 417 RACETRACK RD NW
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-4612
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Country | US
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Telephone | 850-461-0058
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Fax |
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Provider Business Mailing Address
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Address Line | 7808 FENWICK ST
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City | NAVARRE
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State | FL
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Zip | 32566-2702
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Country | US
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Telephone | 850-461-0058
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM KELLEY
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Credential | P.T.
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Telephone | 850-461-0058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT7404
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License Number State | FL
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