Provider Demographics
NPI:1306983911
Name:WHOLISTIC PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:WHOLISTIC PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAMIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-982-1566
Mailing Address - Street 1:4157 EAGLE ROCK BLVD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-4492
Mailing Address - Country:US
Mailing Address - Phone:323-982-1566
Mailing Address - Fax:323-982-1680
Practice Address - Street 1:4157 EAGLE ROCK BLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-4492
Practice Address - Country:US
Practice Address - Phone:323-982-1566
Practice Address - Fax:323-982-1680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy