Provider Demographics
NPI:1437988961
Name:BH OSTEOPRACTIC PHYSIOTHERAPY, LLC
Entity type:Organization
Organization Name:BH OSTEOPRACTIC PHYSIOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:718-304-4898
Mailing Address - Street 1:2500 E HALLANDALE BEACH BLVD STE 611
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4839
Mailing Address - Country:US
Mailing Address - Phone:561-608-0942
Mailing Address - Fax:561-896-2071
Practice Address - Street 1:2500 E HALLANDALE BEACH BLVD STE 611
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4839
Practice Address - Country:US
Practice Address - Phone:561-608-0942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-01
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty