Provider Demographics
NPI:1700338852
Name:THERAPEUTIC PILATES, LLC
Entity Type:Organization
Organization Name:THERAPEUTIC PILATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:CAIN
Authorized Official - Last Name:LANGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:662-242-3789
Mailing Address - Street 1:101 S LAFAYETTE ST
Mailing Address - Street 2:SUITE 17
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-2914
Mailing Address - Country:US
Mailing Address - Phone:662-242-3789
Mailing Address - Fax:
Practice Address - Street 1:101 S LAFAYETTE ST
Practice Address - Street 2:SUITE 17
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2914
Practice Address - Country:US
Practice Address - Phone:662-242-3789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT3788261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy