Healthcare Provider Details

I. General information

NPI: 1255922621
Provider Name (Legal Business Name): FIFE THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 MALL TER
SAVANNAH GA
31406-3602
US

IV. Provider business mailing address

6 MALL TER
SAVANNAH GA
31406-3602
US

V. Phone/Fax

Practice location:
  • Phone: 912-239-6140
  • Fax: 912-335-3539
Mailing address:
  • Phone: 912-239-6140
  • Fax: 912-335-3539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: ALIA ALLEN
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 912-754-0175