Provider Demographics
NPI:1588094270
Name:MAGUIRE THERAPY SERVICES, INC
Entity type:Organization
Organization Name:MAGUIRE THERAPY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:AGNES
Authorized Official - Last Name:MAGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:706-831-5562
Mailing Address - Street 1:2258 WRIGHTSBORO RD
Mailing Address - Street 2:SUMMERVILLE PROFESSIONAL BUILDING SUITE 250
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-4887
Mailing Address - Country:US
Mailing Address - Phone:706-724-6543
Mailing Address - Fax:
Practice Address - Street 1:720 RIVERFRONT DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-1969
Practice Address - Country:US
Practice Address - Phone:706-831-5562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011301261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center