Provider Demographics
NPI:1932796935
Name:MOBILE THERAPY NOW
Entity type:Organization
Organization Name:MOBILE THERAPY NOW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-875-4985
Mailing Address - Street 1:1211 S MAIN ST STE 500
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-0822
Mailing Address - Country:US
Mailing Address - Phone:770-875-4985
Mailing Address - Fax:469-546-2426
Practice Address - Street 1:1211 S MAIN ST STE 500
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-0822
Practice Address - Country:US
Practice Address - Phone:770-875-4985
Practice Address - Fax:469-546-2426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4149288Medicaid