Provider Demographics
NPI:1669165270
Name:ULTRA THERAPY SOLUTIONS
Entity type:Organization
Organization Name:ULTRA THERAPY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKHMANCHUK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:214-789-1691
Mailing Address - Street 1:4514 COLE AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-4193
Mailing Address - Country:US
Mailing Address - Phone:214-699-1296
Mailing Address - Fax:
Practice Address - Street 1:4514 COLE AVE STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-4193
Practice Address - Country:US
Practice Address - Phone:214-699-1296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy