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General NPI Number Information
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NPI Number | 1518664010
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Entity Type | Organization
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Legal Business Name | HEALING PULSE PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 02/14/2023
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 122 LINCOLN BLVD STE 203
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City | VENICE
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State | CA
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Zip | 90291-2859
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Country | US
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Telephone | 424-239-9227
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Fax |
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Provider Business Mailing Address
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Address Line | 1613 S SPAULDING AVE
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City | LOS ANGELES
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State | CA
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Zip | 90019-3845
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Country | US
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Telephone | 312-810-2181
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. STACY BROOKE STERN
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Credential | DPT
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Telephone | 312-810-2181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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