Healthcare Provider Details

I. General information

NPI: 1962032755
Provider Name (Legal Business Name): SENIOR THERAPY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 12/28/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4814 HAMLIN GROVES TRL STE B
WINTER GARDEN FL
34787-4170
US

IV. Provider business mailing address

PO BOX 168
CRYSTAL SPRINGS MS
39059-0168
US

V. Phone/Fax

Practice location:
  • Phone: 407-287-6603
  • Fax: 850-391-4114
Mailing address:
  • Phone: 850-588-9641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE SUTTERFIELD WALTERS
Title or Position: OWNER
Credential:
Phone: 601-308-5117