Provider Demographics
NPI:1861796831
Name:THERAPIEZENTRUM IM KLINIKVERBUND SUEDWEST
Entity type:Organization
Organization Name:THERAPIEZENTRUM IM KLINIKVERBUND SUEDWEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GESCHAEFTSFUEHRER
Authorized Official - Prefix:
Authorized Official - First Name:BOLTZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:0049703-187-9504
Mailing Address - Street 1:RATHAUSPLATZ 5
Mailing Address - Street 2:
Mailing Address - City:SINDELFINGEN
Mailing Address - State:STUTTGART
Mailing Address - Zip Code:71065
Mailing Address - Country:DE
Mailing Address - Phone:0049703-187-9504
Mailing Address - Fax:0049703-187-9557
Practice Address - Street 1:RATHAUSPLATZ 5
Practice Address - Street 2:
Practice Address - City:SINDELFINGEN
Practice Address - State:STUTTGART
Practice Address - Zip Code:71065
Practice Address - Country:DE
Practice Address - Phone:0049703-187-9504
Practice Address - Fax:0049703-187-9557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ244818261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy