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General NPI Number Information
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NPI Number | 1386790525
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Entity Type | Organization
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Legal Business Name | INTEGRATED THERAPY SERVICES
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Dates
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Enumeration Date | 01/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 40 BROAD STREET RD
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City | MANAKIN SABOT
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State | VA
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Zip | 23103-2213
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Country | US
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Telephone | 804-784-3514
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Fax |
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Provider Business Mailing Address
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Address Line | 6013 RESTINGWAY LN
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City | RICHMOND
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State | VA
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Zip | 23234-5565
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Country | US
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Telephone | 804-275-4240
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MS. GERI P ALLEN
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Credential | O.T.
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Telephone | 804-784-3514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0119000846
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License Number State | VA
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