Provider Demographics
NPI:1316561962
Name:TELETHERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:TELETHERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAHASHINI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIDOO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:731-334-8567
Mailing Address - Street 1:710 US HIGHWAY 51 BYP N
Mailing Address - Street 2:PMB 574
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-1950
Mailing Address - Country:US
Mailing Address - Phone:731-334-2919
Mailing Address - Fax:
Practice Address - Street 1:1445 PARR AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-3153
Practice Address - Country:US
Practice Address - Phone:731-334-2919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty