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General NPI Number Information
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NPI Number | 1174246417
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Entity Type | Organization
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Legal Business Name | MILLSTONE THERAPY GROUP LLC
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 8452 HESSIAN HILL CT
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City | BRISTOW
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State | VA
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Zip | 20136-1166
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Country | US
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Telephone | 304-228-5444
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Fax |
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Provider Business Mailing Address
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Address Line | 8452 HESSIAN HILL CT
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City | BRISTOW
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State | VA
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Zip | 20136-1166
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Country | US
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Telephone | 304-228-5444
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREA CLINE LAFFERTY
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Credential |
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Telephone | 304-228-5444
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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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