Provider Demographics
NPI:1073300604
Name:PINK SISTERS THERAPY SERVICES LLC
Entity type:Organization
Organization Name:PINK SISTERS THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA TERESITA
Authorized Official - Middle Name:SANTIAGO
Authorized Official - Last Name:GOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-720-8359
Mailing Address - Street 1:1699 ASPEN GREEN CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-0641
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1699 ASPEN GREEN CV
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-0641
Practice Address - Country:US
Practice Address - Phone:601-720-8359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty