Healthcare Provider Details

I. General information

NPI: 1245683648
Provider Name (Legal Business Name): MOBILE THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 MAIN ST
DALLAS PA
18612-1640
US

IV. Provider business mailing address

27 MAIN ST
DALLAS PA
18612-1640
US

V. Phone/Fax

Practice location:
  • Phone: 570-282-9382
  • Fax: 570-227-1891
Mailing address:
  • Phone: 570-282-9382
  • Fax: 570-227-1891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHARLES ANTHONY STEVENS
Title or Position: OWNER
Credential: DPT
Phone: 570-282-9382