Healthcare Provider Details

I. General information

NPI: 1558073866
Provider Name (Legal Business Name): PREMIER THERAPY BILLING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 N 15TH AVE
PENSACOLA FL
32503-4730
US

IV. Provider business mailing address

2201 N 15TH AVE
PENSACOLA FL
32503-4730
US

V. Phone/Fax

Practice location:
  • Phone: 318-229-6208
  • Fax:
Mailing address:
  • Phone: 318-229-6208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: AMY HOBBS
Title or Position: OWNER
Credential: PT, DPT
Phone: 318-229-6208