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
21 WILEY AVENUE SOUTH, LIDGERWOOD, ND 58053-4001
(701) 538-4189
(701) 538-4319
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
—
1346007
BCBS ND CLNIC #
ND
05
—
55416
—
ND
01
—
CG3429
TRAVELERS MEDICARE
ND
Enumeration date
08/07/2006
Last updated
06/09/2009
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