Providence Therapy Services Llc

LBN: Providence Therapy Services Llc
Providence Therapy Services Llc is an health care organization with primary practice located at 21037 Holden Drive , Davenport IA 52804. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as the primary health care specialty. Providence Therapy Services Llc can be contacted via phone (563) 359-4054, or through Gillund, Marlene R via phone (563) 359-4054.

Contact Information

Primary practice address
21037 Holden Drive Davenport IA 52804
Phone: (563) 359-4054
Fax: (563) 359-4084
Website:
Map and Directions
Authorized official contact:
Name: Gillund, Marlene R
Phone: (563) 359-4054

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X

Profile Details

NPI number 1669532388
LBN Legal business name Providence Therapy Services Llc
DBA Doing business as
Authorized official Gillund, Marlene R
Entity Organization
Organization subpart 1 No
Enumeration date Dec 11th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669532388 NPPES
Iowa MEDICAID 0474460

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