Provider Demographics
NPI:1366826851
Name:FIFE THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:FIFE THERAPY SERVICES, LLC
Other - Org Name:FIFE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-441-1009
Mailing Address - Street 1:6 MALL TER
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3602
Mailing Address - Country:US
Mailing Address - Phone:912-239-6140
Mailing Address - Fax:912-335-3539
Practice Address - Street 1:6 MALL TER
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3602
Practice Address - Country:US
Practice Address - Phone:912-239-6140
Practice Address - Fax:912-335-3539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty