Provider Demographics
NPI:1073576559
Name:PROFESSIONAL THERAPY SYSTEMS INC
Entity Type:Organization
Organization Name:PROFESSIONAL THERAPY SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-972-1100
Mailing Address - Street 1:1605 GUNBARREL RD
Mailing Address - Street 2:STE A
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3126
Mailing Address - Country:US
Mailing Address - Phone:423-855-0283
Mailing Address - Fax:
Practice Address - Street 1:1605 GUNBARREL RD
Practice Address - Street 2:STE A
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3126
Practice Address - Country:US
Practice Address - Phone:423-855-0283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN446600Medicare Oscar/Certification