Provider Demographics
NPI:1750761565
Name:ADVANCED THERAPY SERVICES LLC
Entity type:Organization
Organization Name:ADVANCED THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LETRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-515-3196
Mailing Address - Street 1:4229 HUNT DR APT 4306
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-3263
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4229 HUNT DR APT 4306
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-3263
Practice Address - Country:US
Practice Address - Phone:469-515-3196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX438390360251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health