Provider Demographics
NPI:1841527561
Name:ASSOCIATED THERAPUTIC SERVICES
Entity type:Organization
Organization Name:ASSOCIATED THERAPUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHABILITATION SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELEA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:BSRS
Authorized Official - Phone:580-402-2576
Mailing Address - Street 1:1625 W OWEN K GARRIOTT RD
Mailing Address - Street 2:STE F
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-5653
Mailing Address - Country:US
Mailing Address - Phone:580-242-4673
Mailing Address - Fax:
Practice Address - Street 1:1625 W OWEN K GARRIOTT RD
Practice Address - Street 2:STE F
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-5653
Practice Address - Country:US
Practice Address - Phone:580-242-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health