Provider Demographics
NPI:1760072185
Name:DELANEY THERAPY INNOVATIONS
Entity Type:Organization
Organization Name:DELANEY THERAPY INNOVATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:R
Authorized Official - Last Name:DELANEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:618-416-5388
Mailing Address - Street 1:13 S MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SMITHTON
Mailing Address - State:IL
Mailing Address - Zip Code:62285-1705
Mailing Address - Country:US
Mailing Address - Phone:618-416-5388
Mailing Address - Fax:618-722-5301
Practice Address - Street 1:13 S MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:SMITHTON
Practice Address - State:IL
Practice Address - Zip Code:62285-1705
Practice Address - Country:US
Practice Address - Phone:618-416-5388
Practice Address - Fax:618-722-5301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JASON R DELANEY. DENTAL THERAPY INNOVATIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy