Healthcare Provider Details

I. General information

NPI: 1497660393
Provider Name (Legal Business Name): MOBILE OT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8004 W PALMETTO ST
WICHITA KS
67205-5210
US

IV. Provider business mailing address

8004 W PALMETTO ST
WICHITA KS
67205-5210
US

V. Phone/Fax

Practice location:
  • Phone: 316-409-1719
  • Fax:
Mailing address:
  • Phone: 316-409-1719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMY M ADAMSON
Title or Position: OWNER
Credential: ADAMSON
Phone: 316-409-1719