Provider Demographics
NPI:1053639781
Name:PROFESSIONAL THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:PROFESSIONAL THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-234-9705
Mailing Address - Street 1:211 E HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:NEW BADEN
Mailing Address - State:IL
Mailing Address - Zip Code:62265-1811
Mailing Address - Country:US
Mailing Address - Phone:618-588-4000
Mailing Address - Fax:618-588-4800
Practice Address - Street 1:211 E HANOVER ST
Practice Address - Street 2:
Practice Address - City:NEW BADEN
Practice Address - State:IL
Practice Address - Zip Code:62265-1811
Practice Address - Country:US
Practice Address - Phone:618-588-4000
Practice Address - Fax:618-588-4800
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROFESSIONAL THERAPY SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty