Provider Demographics
NPI:1164797973
Name:THERAPY SOLUTIONS LLC
Entity Type:Organization
Organization Name:THERAPY SOLUTIONS LLC
Other - Org Name:ADVANCED THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:SANTINE LANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:228-354-0093
Mailing Address - Street 1:4063 GINGER DR
Mailing Address - Street 2:STE C
Mailing Address - City:DIBERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39540-3705
Mailing Address - Country:US
Mailing Address - Phone:228-354-0093
Mailing Address - Fax:228-354-0094
Practice Address - Street 1:4063 GINGER DR
Practice Address - Street 2:STE C
Practice Address - City:DIBERVILLE
Practice Address - State:MS
Practice Address - Zip Code:39540-3705
Practice Address - Country:US
Practice Address - Phone:228-354-0093
Practice Address - Fax:228-354-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0121391Medicaid
MS0121391Medicaid