Healthcare Provider Details

I. General information

NPI: 1760812663
Provider Name (Legal Business Name): THERAPY PARTNER SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2013
Last Update Date: 08/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 VILLAGE TRL
PORT ORANGE FL
32127-9353
US

IV. Provider business mailing address

PO BOX 1975
ROME GA
30162-1975
US

V. Phone/Fax

Practice location:
  • Phone: 386-872-7511
  • Fax: 866-647-2045
Mailing address:
  • Phone: 706-236-2755
  • Fax: 866-647-2045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES CHADWICK WHITEFIELD
Title or Position: PARTNER/PRESIDENT
Credential: PTA
Phone: 904-753-1624