Healthcare Provider Details

I. General information

NPI: 1386361459
Provider Name (Legal Business Name): YES THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 E COOPER ST
GREEN RIDGE MO
65332-1025
US

IV. Provider business mailing address

104 E COOPER ST
GREEN RIDGE MO
65332-1025
US

V. Phone/Fax

Practice location:
  • Phone: 660-988-4902
  • Fax:
Mailing address:
  • Phone: 660-988-4902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: COBY THRAILKILL
Title or Position: OWNER
Credential: PTA
Phone: 166-098-8490