Provider Demographics
NPI:1164119764
Name:INNOVATIVE THERAPY SPECIALISTS, INC
Entity Type:Organization
Organization Name:INNOVATIVE THERAPY SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPER
Authorized Official - Middle Name:D
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-843-6258
Mailing Address - Street 1:67 SE 103RD ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-7806
Mailing Address - Country:US
Mailing Address - Phone:352-843-6258
Mailing Address - Fax:
Practice Address - Street 1:67 SE 103RD ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-7806
Practice Address - Country:US
Practice Address - Phone:352-843-6258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy