Provider Demographics
NPI:1225306723
Name:ORIENTAL THERAPY CENTER LLC
Entity Type:Organization
Organization Name:ORIENTAL THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:954-603-1311
Mailing Address - Street 1:8771 STIRLING RD
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5932
Mailing Address - Country:US
Mailing Address - Phone:954-603-1311
Mailing Address - Fax:954-252-5199
Practice Address - Street 1:8771 STIRLING RD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-5932
Practice Address - Country:US
Practice Address - Phone:954-603-1311
Practice Address - Fax:954-252-5199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP152171100000X
FLAP1971171100000X
FLMA61412225700000X
FLMA42873225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA42873OtherMASSAGE THERAPY
FLAP152OtherACUPUNCTURE
FLAP1971OtherACUPUNCTURE
FLMA61412OtherMASSAGE THERAPY