Provider Demographics
NPI:1487152146
Name:DX THERAPY LLC
Entity type:Organization
Organization Name:DX THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUCHENEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:605-222-3934
Mailing Address - Street 1:PO BOX 905
Mailing Address - Street 2:
Mailing Address - City:EAGLE BUTTE
Mailing Address - State:SD
Mailing Address - Zip Code:57625-0905
Mailing Address - Country:US
Mailing Address - Phone:605-222-3934
Mailing Address - Fax:
Practice Address - Street 1:16734 BIA RTE 8 ARMSTRONG
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:SD
Practice Address - Zip Code:57442
Practice Address - Country:US
Practice Address - Phone:605-222-3934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy