Boutique Bodyworks

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

682970000 Issued in TX

Legal business name

BOUTIQUE BODYWORKS

Practice address

9518 Wahada Ave
San Antonio, TX 78217-5033

Phone

(210) 563-1070

Fax

(210) 876-1212

NPI assigned

Dec 11, 2017

Last updated

Jan 11, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alina Acebo Kulczycki, PT, DPT.

Title

Owner and Practitioner

Phone

(210) 563-1070

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1558876649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9518 WAHADA AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175033",
            "telephone_number": "210-563-1070",
            "fax_number": "210-876-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9518 WAHADA AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175033",
            "telephone_number": "210-563-1070",
            "fax_number": "210-876-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUTIQUE BODYWORKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-11",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "ACEBO KULCZYCKI",
        "authorized_official_first_name": "ALINA",
        "authorized_official_title_or_position": "OWNER AND PRACTITIONER",
        "authorized_official_telephone_number": "210-563-1070",
        "authorized_official_credential": "PT, DPT."
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "682970000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Lynn Bourland, NP
• Sarah D Bourland, M.D.
• Ellen Rose Bourne, CNA
• Ryan Noland Bourne, M.D.
• Madeleine Bousquet, MD
• Rachaell Boutot
• Robin Boutwell, LPC
• Stephanie Anne Bouvier, M.D.
• Pamela Bovaird, QMHP-CS
• Virginia Ann Bovermann, LMSW

• Physical Therapy Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.