Basic Information
| Provider Information | |||||||||
| NPI: | 1790758027 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AT HOME THERAPY FOR YOU | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16237 SW 15TH ST | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330275128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544470051 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16237 SW 15TH ST | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330275128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544470051 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BLOYER | ||||||||
| AuthorizedOfficialFirstName: | MARTHA | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9544470051 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.