Provider Demographics
NPI:1689295206
Name:BTS DYNAMICS LLC
Entity Type:Organization
Organization Name:BTS DYNAMICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOUCES
Authorized Official - Prefix:MR
Authorized Official - First Name:TYSON
Authorized Official - Middle Name:WALLACE
Authorized Official - Last Name:SCHILLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-517-2798
Mailing Address - Street 1:1936 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-4570
Mailing Address - Country:US
Mailing Address - Phone:573-334-4111
Mailing Address - Fax:573-334-1118
Practice Address - Street 1:1936 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-4570
Practice Address - Country:US
Practice Address - Phone:573-334-4111
Practice Address - Fax:573-334-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care