Provider Demographics
NPI:1568089696
Name:THERAPY IN HOME
Entity Type:Organization
Organization Name:THERAPY IN HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NURCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:772-777-0888
Mailing Address - Street 1:302 NW BINGHAMPTON LN
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-3434
Mailing Address - Country:US
Mailing Address - Phone:772-777-0888
Mailing Address - Fax:
Practice Address - Street 1:302 NW BINGHAMPTON LN
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-3434
Practice Address - Country:US
Practice Address - Phone:772-777-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy