Provider Demographics
NPI:1366040735
Name:INNOVATIVE THERAPY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:INNOVATIVE THERAPY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAITLYN
Authorized Official - Middle Name:CAREY
Authorized Official - Last Name:DONEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:985-859-3782
Mailing Address - Street 1:1671 SARATOGA DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-9025
Mailing Address - Country:US
Mailing Address - Phone:985-859-3782
Mailing Address - Fax:
Practice Address - Street 1:1671 SARATOGA DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-9025
Practice Address - Country:US
Practice Address - Phone:985-859-3782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty