Provider Demographics
NPI:1376829895
Name:2GETHER IQR HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:2GETHER IQR HEALTH CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:MADISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-634-7106
Mailing Address - Street 1:512 N HAMPTON RD # 261
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4920
Mailing Address - Country:US
Mailing Address - Phone:903-634-7106
Mailing Address - Fax:214-258-7129
Practice Address - Street 1:512 N HAMPTON RD # 261
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4920
Practice Address - Country:US
Practice Address - Phone:903-634-7106
Practice Address - Fax:214-258-7129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty