Playwell Pediatric Therapy LLC
Occupational Therapist, Pediatrics in Dalton Gardens, ID. Organization (NPI-2).
NPI number1215776455
StatusActive
Last updated in NPPESJul 1, 2024
Details
- NPI
- 1215776455
- Entity type
- Organization (NPI-2)
- Legal business name
- Playwell Pediatric Therapy LLC
- Organization subpart
- No
- Enumeration date
- May 20, 2024
- Certification date
- Jul 1, 2024
- Last updated
- Jul 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225XP0200X | Occupational Therapist, Pediatrics | – | – | Yes |
| 261QX0100X | Clinic/Center, Occupational Medicine | – | – |
Practice location
7047 N 15th StDalton Gardens, ID 83815-9595
Phone 562-212-6891
Mailing address
7047 N 15th StDalton Gardens, ID 83815-9595
Phone 562-212-6891
Authorized official
Lanmana Parys-Wolodkewitsch
Owner
5622126891
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