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General NPI Number Information
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NPI Number | 1487306809
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Entity Type | Organization
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Legal Business Name | BANKS THERAPY SERVICES LLC
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Dates
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Enumeration Date | 01/26/2022
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Last Update Date | 01/26/2022
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Provider Practice Location Address
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Address Line | 12522 LAKE MADISON LN
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City | JACKSONVILLE
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State | FL
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Zip | 32218-7539
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Country | US
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Telephone | 904-707-1355
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Fax |
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Provider Business Mailing Address
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Address Line | 12522 LAKE MADISON LN
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City | JACKSONVILLE
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State | FL
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Zip | 32218-7539
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Country | US
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Telephone |
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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 | ANTWANETTE BANKS
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Credential | OT/L, CLT
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Telephone | 904-707-1355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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