Provider Demographics
NPI:1104426352
Name:PEDIATRIC THERAPY PARTNERS, INC.
Entity type:Organization
Organization Name:PEDIATRIC THERAPY PARTNERS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP & SR. ASST GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:RODENBERG-ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-836-2234
Mailing Address - Street 1:3060 FRONTIER WAY S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8909
Mailing Address - Country:US
Mailing Address - Phone:701-364-3945
Mailing Address - Fax:701-364-3946
Practice Address - Street 1:3060 FRONTIER WAY S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8909
Practice Address - Country:US
Practice Address - Phone:701-364-3945
Practice Address - Fax:701-364-3946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency