Provider Demographics
NPI:1407293640
Name:THERAPY MANAGEMENT INC
Entity Type:Organization
Organization Name:THERAPY MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-864-8171
Mailing Address - Street 1:851 PENNIMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1621
Mailing Address - Country:US
Mailing Address - Phone:877-864-8171
Mailing Address - Fax:989-509-5965
Practice Address - Street 1:3000 MONROE AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-3313
Practice Address - Country:US
Practice Address - Phone:877-864-8171
Practice Address - Fax:989-509-5965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty