Provider Demographics
NPI:1851462485
Name:PROFESSIONAL THERAPY SERVICES INC
Entity Type:Organization
Organization Name:PROFESSIONAL THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SECTRY TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:205-758-0053
Mailing Address - Street 1:PO BOX 2273
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39158-2273
Mailing Address - Country:US
Mailing Address - Phone:205-758-0053
Mailing Address - Fax:205-758-0390
Practice Address - Street 1:1110 15TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-3392
Practice Address - Country:US
Practice Address - Phone:205-758-0053
Practice Address - Fax:205-758-0390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALJ159Medicare ID - Type UnspecifiedMEDICARE FACILITY NUMBER