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General NPI Number Information
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NPI Number | 1043881493
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Entity Type | Organization
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Legal Business Name | POND PEDIATRIC THERAPY
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Dates
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Enumeration Date | 07/07/2021
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 599 N CENTENNIAL AVE
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City | WEST FORK
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State | AR
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Zip | 72774-2711
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Country | US
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Telephone | 479-595-2570
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 S PUMPKIN RIDGE DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-7769
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Country | US
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Telephone | 479-595-2570
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MRS. SARAH KATHERINE POND
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Credential | OTR/L
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Telephone | 479-595-2570
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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 |
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License Number State |
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