Therapeutic, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

THERAPEUTIC, LLC

Doing business as

THERAPEUTIC, LLC

Practice address

8402 E Interstate 20
Aledo, TX 76008-3204

Phone

(817) 262-3313

Fax

(817) 882-9700

NPI assigned

Feb 19, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jasyn Michael Mamantov, PTNPI 1316578230

Title

Director

Phone

(817) 709-8406

Specialties & licenses 1

Addresses

Other names 1

• THERAPEUTIC, LLC Doing business as

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jasyn M Mamantov, PHYSICAL THERAPIST

  • Physical Therapist
  • Joshua, TX
  • NPI 1316578230
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1578196333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 E INTERSTATE 20",
            "city": "ALEDO",
            "state": "TX",
            "postal_code": "760083204",
            "telephone_number": "817-262-3313",
            "fax_number": "817-882-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 E INTERSTATE 20",
            "city": "ALEDO",
            "state": "TX",
            "postal_code": "760083204",
            "telephone_number": "817-262-3313",
            "fax_number": "817-882-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "MAMANTOV",
        "authorized_official_first_name": "JASYN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-709-8406",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "therapeuticllcjm@gmail.com",
            "affiliation": "N",
            "address_1": "8402 E Interstate 20",
            "city": "Aledo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760083204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "THERAPEUTIC, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapy Clinic/Center in Aledo, TX
• Providers in Aledo, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.