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General NPI Number Information
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NPI Number | 1003365305
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Entity Type | Organization
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Legal Business Name | INNOVATIONS THERAPY
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Dates
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Enumeration Date | 09/27/2016
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 608 BRYAN DR
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City | DURANT
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State | OK
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Zip | 74701-3462
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Country | US
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Telephone | 214-537-2344
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Fax |
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Provider Business Mailing Address
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Address Line | 608 BRYAN DR
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City | DURANT
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State | OK
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Zip | 74701-3462
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ OCCUPATIONAL THERAPIST
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Name | CHERI MORSE
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Credential | MOTR/L
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Telephone | 214-537-2344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1513
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License Number State | OK
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