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General NPI Number Information
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NPI Number | 1437174158
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Entity Type | Organization
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Legal Business Name | INNOVATIVE THERAPY SERVICES INC
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 13910 JOG RD STE 102
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City | DELRAY BEACH
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State | FL
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Zip | 33446-5908
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Country | US
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Telephone | 561-824-0234
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Fax | 561-824-0235
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Provider Business Mailing Address
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Address Line | 1602 N LAKESIDE DR
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City | LAKE WORTH
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State | FL
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Zip | 33460-6610
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Country | US
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Telephone | 561-824-0234
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Fax | 561-824-0235
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Authorized Official
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Title or Position | VICEPRESIDENT
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Name | MRS. GWENDOLYN JEAN BOYD
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Credential | PT
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Telephone | 561-824-0234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | FL
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