Provider Demographics
NPI:1639289812
Name:THERAPY RESOURCES,LLC
Entity Type:Organization
Organization Name:THERAPY RESOURCES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MYRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOLTON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:256-543-1030
Mailing Address - Street 1:1514 OWENS ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35904-4938
Mailing Address - Country:US
Mailing Address - Phone:256-543-1030
Mailing Address - Fax:256-439-2830
Practice Address - Street 1:1514 OWENS ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35904-4938
Practice Address - Country:US
Practice Address - Phone:256-543-1030
Practice Address - Fax:256-439-2830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK179OtherMEDICARE IDENTIFICATION N
ALK179OtherMEDICARE IDENTIFICATION N