# PROVIDENCE THERAPY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE THERAPY SERVICES LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477808533
- **Legal business name:** PROVIDENCE THERAPY SERVICES LLC
- **Authorized official:** GENA HUMMEL (OFFICE MANAGER - BILLING)
- **Authorized official phone:** (563) 242-1170

## Contact information

- **Practice address:** 2320 N 2ND ST, CLINTON, IA 52732-2434
- **Practice address phone:** (563) 243-2285
- **Practice address fax:** (563) 243-2293
- **Mailing address:** 2320 N 2ND ST, CLINTON, IA 52732-2434
- **Mailing address phone:** (563) 243-2285
- **Mailing address fax:** (563) 243-2293

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | 00085 | IA | Yes |

## Other

- **Enumeration date:** 07/16/2012
- **Last updated:** 07/30/2014