Provider Demographics
NPI:1083921829
Name:THERAPY VALLEY SERVICES, INC.
Entity Type:Organization
Organization Name:THERAPY VALLEY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:HATTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPTA
Authorized Official - Phone:405-926-7297
Mailing Address - Street 1:512 N CHICKASAW ST
Mailing Address - Street 2:
Mailing Address - City:PAULS VALLEY
Mailing Address - State:OK
Mailing Address - Zip Code:73075-2408
Mailing Address - Country:US
Mailing Address - Phone:405-926-7297
Mailing Address - Fax:
Practice Address - Street 1:512 N CHICKASAW ST
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-2408
Practice Address - Country:US
Practice Address - Phone:405-926-7297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK341224Z00000X
OKTA539225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty