Provider Demographics
NPI:1699002188
Name:ENDURACARE THERAPY MANAGEMENT, INC
Entity Type:Organization
Organization Name:ENDURACARE THERAPY MANAGEMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF QUALITY ASSURANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PIDICH
Authorized Official - Suffix:
Authorized Official - Credentials:MSCCCSLP
Authorized Official - Phone:866-439-5909
Mailing Address - Street 1:51461 JENNIFER LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9378
Mailing Address - Country:US
Mailing Address - Phone:877-244-9917
Mailing Address - Fax:740-526-0993
Practice Address - Street 1:51461 JENNIFER LN
Practice Address - Street 2:SUITE 110
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9378
Practice Address - Country:US
Practice Address - Phone:877-244-9917
Practice Address - Fax:740-526-0993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation