Organization
DYNAMIC THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
(252) 248-3313
Entity
Organization
Contact information
Practice address
37155 REHOBOTH AVENUE EXT, REHOBOTH BEACH, DE 19971-3194
(302) 227-2008
(302) 227-8098
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(252) 248-3313
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
10/22/2020
Last updated
12/09/2024
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