Provider Demographics
NPI:1053468090
Name:MIDLANDS THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:MIDLANDS THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:WORKMAN
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:803-359-3195
Mailing Address - Street 1:PO BOX 708
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29071-0708
Mailing Address - Country:US
Mailing Address - Phone:803-359-3195
Mailing Address - Fax:803-359-3195
Practice Address - Street 1:225 VISTA SPRINGS CIR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-8119
Practice Address - Country:US
Practice Address - Phone:803-359-3195
Practice Address - Fax:803-359-3195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3725Medicaid