Provider Demographics
NPI:1932279619
Name:THERAPEUTIC INTERVENTIONS THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:THERAPEUTIC INTERVENTIONS THERAPY SERVICES, PLLC
Other - Org Name:THERAPEUTIC INTERVENTIONS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HERBIG
Authorized Official - Suffix:II
Authorized Official - Credentials:PT
Authorized Official - Phone:502-222-6446
Mailing Address - Street 1:PO BOX 789
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-0789
Mailing Address - Country:US
Mailing Address - Phone:502-222-6446
Mailing Address - Fax:502-222-5109
Practice Address - Street 1:114 W CRYSTAL DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:LAGRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031
Practice Address - Country:US
Practice Address - Phone:502-222-6446
Practice Address - Fax:502-222-5109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty