Roots Pediatric Therapy
Occupational Therapist, Pediatrics in Park City, UT. Organization (NPI-2).
NPI number1962024943
StatusActive
Last updated in NPPESMay 12, 2020
Details
- NPI
- 1962024943
- Entity type
- Organization (NPI-2)
- Legal business name
- Roots Pediatric Therapy
- Organization subpart
- No
- Enumeration date
- May 12, 2020
- Certification date
- May 12, 2020
- Last updated
- May 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225XP0200X | Occupational Therapist, Pediatrics | – | – | Yes |
| 2251P0200X | Physical Therapist, Pediatrics | – | – | |
| 235Z00000X | Speech-Language Pathologist, | – | – |
Practice location
5976 Kingsford AvePark City, UT 84098-6315
Phone 907-744-3978
Mailing address
5976 Kingsford AvePark City, UT 84098-6315
Phone 907-744-3978
Authorized official
Robyn Thompson
Owner
9077443978
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