Provider Demographics
NPI:1487754875
Name:FIRST CHOICE THERAPY SERVICES
Entity type:Organization
Organization Name:FIRST CHOICE THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MALLOY
Authorized Official - Suffix:IV
Authorized Official - Credentials:OT
Authorized Official - Phone:828-894-6588
Mailing Address - Street 1:185 WOODY CIR
Mailing Address - Street 2:
Mailing Address - City:TRYON
Mailing Address - State:NC
Mailing Address - Zip Code:28782-6824
Mailing Address - Country:US
Mailing Address - Phone:828-894-6588
Mailing Address - Fax:828-894-6588
Practice Address - Street 1:185 WOODY CIR
Practice Address - Street 2:
Practice Address - City:TRYON
Practice Address - State:NC
Practice Address - Zip Code:28782-6824
Practice Address - Country:US
Practice Address - Phone:828-894-6588
Practice Address - Fax:828-894-6588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211721Medicaid