Healthcare Provider Details

I. General information

NPI: 1235417577
Provider Name (Legal Business Name): THEREX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 VALHI LAGOON XING
HOUMA LA
70360-3208
US

IV. Provider business mailing address

341 COOL SPRINGS BLVD STE 450
FRANKLIN TN
37067-7221
US

V. Phone/Fax

Practice location:
  • Phone: 985-876-5322
  • Fax:
Mailing address:
  • Phone: 615-236-2550
  • 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
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

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