Provider Demographics
NPI:1053436188
Name:THERAPEUTIC HEALTH SERVICES, INC
Entity type:Organization
Organization Name:THERAPEUTIC HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST EXECUTIVE DIR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:G
Authorized Official - Last Name:HULST
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:712-737-5234
Mailing Address - Street 1:1000 LINCOLN CIR SE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ORANGE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51041-1862
Mailing Address - Country:US
Mailing Address - Phone:712-737-5234
Mailing Address - Fax:712-737-5287
Practice Address - Street 1:1000 LINCOLN CIR SE
Practice Address - Street 2:SUITE 400
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1862
Practice Address - Country:US
Practice Address - Phone:712-737-5234
Practice Address - Fax:712-737-5287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA=========OtherWELLMARK
IAI15357Medicare ID - Type Unspecified