# PROVIDENCE THERAPY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669532388
- **Authorized official:** MARLENE R GILLUND (OFFICE MANAGER)
- **Authorized official phone:** (563) 359-4054

## Contact information

- **Practice address:** 21037 HOLDEN DRIVE, DAVENPORT, IA 52804
- **Practice address phone:** (563) 359-4054
- **Practice address fax:** (563) 359-4084
- **Mailing address:** 21037 HOLDEN DRIVE, DAVENPORT, IA 52804
- **Mailing address phone:** (563) 359-4054
- **Mailing address fax:** (563) 359-4084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 08/22/2020