Southeast Therapy Services Inc
Organization Active NPI Physical Therapy Clinic/Center · Lidgerwood, ND
NPI 1619986601 · NPPES record last updated Jun 9, 2009
Key facts
- NPI
- 1619986601
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- SOUTHEAST THERAPY SERVICES INC
- Practice address
- 21 Wiley Avenue South
Lidgerwood, ND 58053-4001 - Phone
- (701) 538-4189
- Fax
- (701) 538-4319
- 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
National Provider Directory
- Part of
- Southeast Theapy Servic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Yes |
Addresses
Primary practice location
21 Wiley Avenue South
Lidgerwood, ND 58053-4001
Mailing address
PO Box 368
Oakes, ND 58474-0368
Phone (701) 742-3267
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55416 | Medicaid | ND | |
| CG3429 | Other | ND | TRAVELERS MEDICARE |
| 1346007 | Other | ND | BCBS ND CLNIC # |
Other providers in Lidgerwood, ND
- Lidgerwood Dental Office
- Lidgerwood Rural Ambulance Service
- James D Marotzke
- ND Home Health LLC
- Sanford Clinic North
- Sheryl Renee Tisdel
All providers in Lidgerwood, ND · Physical Therapy Clinic/Center in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.