Provider Demographics
NPI:1699855478
Name:INDEPENDENT THERAPY SERVICES, INC
Entity Type:Organization
Organization Name:INDEPENDENT THERAPY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCHIRMER
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:507-553-6645
Mailing Address - Street 1:20069 520TH AVE
Mailing Address - Street 2:
Mailing Address - City:MINNESOTA LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56068
Mailing Address - Country:US
Mailing Address - Phone:507-553-6645
Mailing Address - Fax:507-553-6640
Practice Address - Street 1:150 3RD ST NW
Practice Address - Street 2:
Practice Address - City:WELLS
Practice Address - State:MN
Practice Address - Zip Code:56097
Practice Address - Country:US
Practice Address - Phone:507-553-6645
Practice Address - Fax:507-553-6640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100906225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN18623SCOtherBCBS
MN714258700Medicaid
MN18623SCOtherBCBS