Provider Demographics
NPI:1083672984
Name:ON THE GO THERAPY SERVICES INC
Entity Type:Organization
Organization Name:ON THE GO THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLANK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:941-922-8200
Mailing Address - Street 1:5968 CLARK CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-2715
Mailing Address - Country:US
Mailing Address - Phone:941-922-8200
Mailing Address - Fax:941-343-9402
Practice Address - Street 1:5968 CLARK CENTER AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-2715
Practice Address - Country:US
Practice Address - Phone:941-922-8200
Practice Address - Fax:941-343-9402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY923KOtherBLUE CROSS & BLUE SHIELD
FLDE8062OtherRAILROAD MEDICARE
FLK7640Medicare PIN
FLDE8062OtherRAILROAD MEDICARE