Provider Demographics
NPI:1407942378
Name:THERAPY SPECIALTIES UNLIMITED INC
Entity Type:Organization
Organization Name:THERAPY SPECIALTIES UNLIMITED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALANNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS RPT
Authorized Official - Phone:541-471-0955
Mailing Address - Street 1:225 NE HILLCREST DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-3547
Mailing Address - Country:US
Mailing Address - Phone:541-471-0955
Mailing Address - Fax:541-471-0928
Practice Address - Street 1:225 NE HILLCREST DR
Practice Address - Street 2:SUITE 9
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-3547
Practice Address - Country:US
Practice Address - Phone:541-471-0955
Practice Address - Fax:541-471-0928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR 0710225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR022577Medicaid
OR114451Medicare ID - Type Unspecified