Provider Demographics
NPI:1770635393
Name:THERAPEUTIC RESOURCES INC
Entity Type:Organization
Organization Name:THERAPEUTIC RESOURCES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RUSINOWSKI
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:954-725-9125
Mailing Address - Street 1:5450 W HILLSBORO BLVD
Mailing Address - Street 2:STE # 9
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4317
Mailing Address - Country:US
Mailing Address - Phone:954-725-9125
Mailing Address - Fax:954-725-9135
Practice Address - Street 1:5450 W HILLSBORO BLVD
Practice Address - Street 2:SUITE NINE
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4317
Practice Address - Country:US
Practice Address - Phone:954-725-9125
Practice Address - Fax:954-725-9135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT2586225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSG074567OtherVISTA
FL0007360595OtherAETNA
FLK4980Medicare ID - Type UnspecifiedGROUP NUMBER