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Organization

SOUTHEAST THERAPY SERVICES INC

Active
Parent organization
SOUTHEAST THERAPY SERVICES INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOUTHEAST THERAPY SERVICES INC
Authorized official
THERESA KELLY (ADMINISTRATOR)
(701) 742-3267
Entity
Organization

Contact information

Practice address
102 10TH AVENUE WEST, LISBON, ND 58054-1097
(701) 683-2214
(701) 683-2130
Mailing address
PO BOX 368, OAKES, ND 58474-0368
(701) 742-3267
(701) 742-3201

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1346002
BCBS ND CLINIC#
ND
05
51787
ND
01
CG3429
RAILROAD MEDICARE
ND
Enumeration date
08/07/2006
Last updated
12/02/2008
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