Southeast Therapy Services Inc

Organization Active NPI Physical Therapy Clinic/Center · Forman, ND

NPI 1013926005 · NPPES record last updated Jun 9, 2009

Key facts

NPI
1013926005
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapy Clinic/Center 261QP2000X
Legal business name
SOUTHEAST THERAPY SERVICES INC
Practice address
336 Main Street
Forman, ND 58032-0184
Phone
(701) 724-3221
Fax
(701) 724-3222
NPI assigned
Aug 7, 2006
Organization subpart
Yes
Parent organization (as reported)
SOUTHEAST THERAPY SERVICES INC

Authorized official

Name
Theresa Kelly
Title
Administrator
Phone
(701) 742-3267

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

National Provider Directory

Part of
Southeast Theapy Servic

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Yes

Addresses

Primary practice location

336 Main Street
Forman, ND 58032-0184

Mailing address

PO Box 368
Oakes, ND 58474-0368
Phone (701) 742-3267

Other identifiers

IdentifierTypeStateIssuer
55418MedicaidND
CG3429OtherNDRAILROAD MEDICARE
1346004OtherNDBCBS ND CLINIC#

Other providers in Forman, ND

All providers in Forman, ND · Physical Therapy Clinic/Center in North Dakota

Sources for this page

Verify at the official NPI Registry.