Provider Demographics
NPI:1043604002
Name:PREMIER THERAPY SERVICES
Entity Type:Organization
Organization Name:PREMIER THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:SCOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:856-912-1676
Mailing Address - Street 1:208 W WAYNE TER
Mailing Address - Street 2:APT 18C
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-2946
Mailing Address - Country:US
Mailing Address - Phone:856-912-1676
Mailing Address - Fax:
Practice Address - Street 1:1420 S BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-9130
Practice Address - Country:US
Practice Address - Phone:856-875-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ20-4605075314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility