Provider Demographics
NPI:1669930947
Name:HANDCRAFTED HEALING LLC
Entity type:Organization
Organization Name:HANDCRAFTED HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERKOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:727-914-7318
Mailing Address - Street 1:2011 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8801
Mailing Address - Country:US
Mailing Address - Phone:727-914-7318
Mailing Address - Fax:
Practice Address - Street 1:2011 1ST AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8801
Practice Address - Country:US
Practice Address - Phone:727-914-7318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy