Provider Demographics
NPI:1710324850
Name:THERAPYPROS, LLC
Entity Type:Organization
Organization Name:THERAPYPROS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:573-265-1105
Mailing Address - Street 1:PO BOX 778
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:MO
Mailing Address - Zip Code:65559-0778
Mailing Address - Country:US
Mailing Address - Phone:573-265-1105
Mailing Address - Fax:
Practice Address - Street 1:117 E SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:MO
Practice Address - Zip Code:65559-1646
Practice Address - Country:US
Practice Address - Phone:573-265-1105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2014-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO200174333261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy