Provider Demographics
NPI:1659916302
Name:ABUNDANCE THERAPY LLC
Entity Type:Organization
Organization Name:ABUNDANCE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:STAMPER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:662-279-5910
Mailing Address - Street 1:24 SHADY COVE EXT
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MS
Mailing Address - Zip Code:38827-9781
Mailing Address - Country:US
Mailing Address - Phone:662-279-5910
Mailing Address - Fax:
Practice Address - Street 1:24 SHADY COVE EXT
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MS
Practice Address - Zip Code:38827-9781
Practice Address - Country:US
Practice Address - Phone:662-279-5910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHAEL STAMPER OT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-15
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health