Provider Demographics
NPI:1083865737
Name:DEERING THERAPY SERVICES LTD
Entity Type:Organization
Organization Name:DEERING THERAPY SERVICES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:DEERING
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:928-753-4263
Mailing Address - Street 1:PO BOX 3278
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86402-3278
Mailing Address - Country:US
Mailing Address - Phone:928-753-4263
Mailing Address - Fax:928-753-1173
Practice Address - Street 1:2501 STOCKTON HILL RD
Practice Address - Street 2:SUITE 104
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-4140
Practice Address - Country:US
Practice Address - Phone:928-753-4263
Practice Address - Fax:928-753-1173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5470960001OtherDMERC