Provider Demographics
NPI:1790355170
Name:TKI ENTERPRISES PLLC
Entity Type:Organization
Organization Name:TKI ENTERPRISES PLLC
Other - Org Name:PERFORMANCE POSTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:IGLEHART
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:970-231-8558
Mailing Address - Street 1:4991 14TH ST NW
Mailing Address - Street 2:
Mailing Address - City:GARRISON
Mailing Address - State:ND
Mailing Address - Zip Code:58540-9651
Mailing Address - Country:US
Mailing Address - Phone:701-337-6488
Mailing Address - Fax:
Practice Address - Street 1:275 2ND ST SW
Practice Address - Street 2:STE B
Practice Address - City:GARRISON
Practice Address - State:ND
Practice Address - Zip Code:58540
Practice Address - Country:US
Practice Address - Phone:701-337-6488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy