Provider Demographics
NPI:1598898637
Name:THER EX, INC
Entity Type:Organization
Organization Name:THER EX, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:661-513-9317
Mailing Address - Street 1:23356 TIMBERLANE DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-1450
Mailing Address - Country:US
Mailing Address - Phone:661-513-9317
Mailing Address - Fax:661-513-9348
Practice Address - Street 1:23356 TIMBERLANE DR
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91354-1450
Practice Address - Country:US
Practice Address - Phone:661-513-9317
Practice Address - Fax:661-513-9348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 16807310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16960Medicare ID - Type UnspecifiedPHYSICAL THERAPY