Provider Demographics
NPI:1124442686
Name:THERAPY ESSENTIALS
Entity type:Organization
Organization Name:THERAPY ESSENTIALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-472-0900
Mailing Address - Street 1:5235 CALYX LN
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-2214
Mailing Address - Country:US
Mailing Address - Phone:419-472-0900
Mailing Address - Fax:419-472-0812
Practice Address - Street 1:930 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-4097
Practice Address - Country:US
Practice Address - Phone:419-472-0900
Practice Address - Fax:419-472-0812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008849225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty