Provider Demographics
NPI:1598998973
Name:SOUTH CENTRAL THERAPIES INC
Entity Type:Organization
Organization Name:SOUTH CENTRAL THERAPIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRUSE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:435-529-2234
Mailing Address - Street 1:45 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:UT
Mailing Address - Zip Code:84654-1363
Mailing Address - Country:US
Mailing Address - Phone:435-529-2234
Mailing Address - Fax:435-529-2236
Practice Address - Street 1:45 N STATE ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:UT
Practice Address - Zip Code:84654-1363
Practice Address - Country:US
Practice Address - Phone:435-529-2234
Practice Address - Fax:435-529-2236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT121523-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty