Basic Information
| Provider Information | |||||||||
| NPI: | 1922570548 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SENIOR THERAPY SOLUTIONS | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SENIOR THERAPY SOLUTIONS | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 168 | ||||||||
| Address2: | |||||||||
| City: | CRYSTAL SPRINGS | ||||||||
| State: | MS | ||||||||
| PostalCode: | 390590168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8505889641 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9293 POPLAR AVE | ||||||||
| Address2: | |||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381387921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6013085117 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2018 | ||||||||
| LastUpdateDate: | 01/21/2020 | ||||||||
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| AuthorizedOfficialLastName: | WALTERS | ||||||||
| AuthorizedOfficialFirstName: | SUZANNE | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6012012051 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.