Provider Demographics
NPI:1376697631
Name:UNITED THERAPY GROUP LLC
Entity Type:Organization
Organization Name:UNITED THERAPY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRN
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-367-6355
Mailing Address - Street 1:19804 NE 22ND LN
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:FL
Mailing Address - Zip Code:32640-2900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12801 NE 139TH PL
Practice Address - Street 2:
Practice Address - City:FORT MC COY
Practice Address - State:FL
Practice Address - Zip Code:32134-7765
Practice Address - Country:US
Practice Address - Phone:352-236-0823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty