Healthcare Provider Details

I. General information

NPI: 1730299447
Provider Name (Legal Business Name): THERAPY INNOVATIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

389 KANE STREET
GATE CITY VA
24251
US

IV. Provider business mailing address

PO BOX 1807
GATE CITY VA
24251
US

V. Phone/Fax

Practice location:
  • Phone: 276-386-2424
  • Fax: 276-386-2349
Mailing address:
  • Phone: 276-386-2424
  • Fax: 276-386-2349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: TAMMY LYNN DOCKERY
Title or Position: INS. BILLING MANAGER
Credential:
Phone: 276-386-2424