Healthcare Provider Details

I. General information

NPI: 1285778779
Provider Name (Legal Business Name): QUALITY THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 09/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 MAGNOLIA DR
SMITHFIELD NC
27577-4758
US

IV. Provider business mailing address

640 S MURPHREY RD
CLAYTON NC
27527-9111
US

V. Phone/Fax

Practice location:
  • Phone: 919-989-6594
  • Fax: 919-989-6532
Mailing address:
  • Phone: 919-427-2764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier7211046
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: MRS. ANDREA B MARTIN
Title or Position: OWNER AND PRESIDENT
Credential: PT
Phone: 919-989-6594