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General NPI Number Information
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NPI Number | 1346094950
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Entity Type | Organization
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Legal Business Name | MUSKOGEE THERAPY SPOT LLC
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Dates
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Enumeration Date | 04/11/2024
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 505 N YORK ST
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City | MUSKOGEE
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State | OK
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Zip | 74403-4840
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Country | US
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Telephone | 918-577-7855
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Fax |
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Provider Business Mailing Address
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Address Line | 304 CREEK AVE
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City | FORT GIBSON
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State | OK
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Zip | 74434-8992
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Country | US
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Telephone | 918-577-7855
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Fax |
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Authorized Official
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Title or Position | CO-OWNERS
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Name | MRS. MORGAN SALYER
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Credential | OTR/L
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Telephone | 918-557-7855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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