Provider Demographics
NPI:1174395305
Name:SUPERIOR THERAPY SERVICES, PLLC.
Entity type:Organization
Organization Name:SUPERIOR THERAPY SERVICES, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LAC
Authorized Official - Phone:941-592-0651
Mailing Address - Street 1:2855 ROCK CREEK CIR UNIT 195
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-4617
Mailing Address - Country:US
Mailing Address - Phone:941-592-0651
Mailing Address - Fax:
Practice Address - Street 1:2855 ROCK CREEK CIR UNIT 195
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-4617
Practice Address - Country:US
Practice Address - Phone:941-592-0651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center