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General NPI Number Information
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NPI Number | 1336479971
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 01/04/2010
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 470 NE STEPHENS ST SUITE 102
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City | ROSEBURG
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State | OR
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Zip | 97470-3158
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Country | US
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Telephone | 541-673-5770
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Fax | 541-673-5774
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Provider Business Mailing Address
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Address Line | 470 NE STEPHENS ST SUITE 102
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City | ROSEBURG
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State | OR
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Zip | 97470-3158
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Country | US
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Telephone | 541-673-5770
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Fax | 541-673-5774
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | MR. JAMES DIEMERT
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Credential | OTR
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Telephone | 541-680-7373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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