Provider Demographics
NPI:1760190771
Name:PRIMIER THERAPY SOLUTIONS LLC
Entity Type:Organization
Organization Name:PRIMIER THERAPY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:BAZELAIS
Authorized Official - Suffix:
Authorized Official - Credentials:MOT, OTA
Authorized Official - Phone:786-859-9465
Mailing Address - Street 1:11820 MIRAMAR PKWY STE 203
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5817
Mailing Address - Country:US
Mailing Address - Phone:786-859-9465
Mailing Address - Fax:
Practice Address - Street 1:11820 MIRAMAR PKWY STE 203
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5817
Practice Address - Country:US
Practice Address - Phone:954-699-6232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy