Healthcare Provider Details

I. General information

NPI: 1063635449
Provider Name (Legal Business Name): THEREX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

778 SCOGIN DR
MONTICELLO AR
71655-5729
US

IV. Provider business mailing address

341 COOL SPRINGS BLVD STE 450
FRANKLIN TN
37067-7275
US

V. Phone/Fax

Practice location:
  • Phone: 870-460-3540
  • Fax: 870-460-0531
Mailing address:
  • Phone: 615-236-2550
  • Fax: 615-236-2552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. MIKE SKIERA
Title or Position: CEO
Credential:
Phone: 615-236-2550