Provider Demographics
NPI:1164690145
Name:THERAPY DYNAMICS, INC.
Entity Type:Organization
Organization Name:THERAPY DYNAMICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERSON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-729-8922
Mailing Address - Street 1:1728 WYLDS RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-4353
Mailing Address - Country:US
Mailing Address - Phone:706-729-8922
Mailing Address - Fax:706-729-8926
Practice Address - Street 1:1728 WYLDS RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-4353
Practice Address - Country:US
Practice Address - Phone:706-729-8922
Practice Address - Fax:706-729-8926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies