Provider Demographics
NPI:1245238906
Name:UNITED THERAPY SERVICES, INC.
Entity type:Organization
Organization Name:UNITED THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:414-339-7871
Mailing Address - Street 1:9729 W VIGO TER
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-3647
Mailing Address - Country:US
Mailing Address - Phone:414-339-7871
Mailing Address - Fax:
Practice Address - Street 1:3209 S LAKE DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53235-3712
Practice Address - Country:US
Practice Address - Phone:414-339-7871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4806-024261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41814000Medicaid
WI41814000Medicaid