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General NPI Number Information
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NPI Number | 1457788127
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Entity Type | Organization
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Legal Business Name | INDEPENDENT OPPORTUNITIES,LLC
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Dates
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Enumeration Date | 09/26/2013
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Last Update Date | 09/26/2013
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Provider Practice Location Address
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Address Line | 111 S JEFFERSON ST STE 100
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City | CASPER
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State | WY
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Zip | 82601-2665
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Country | US
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Telephone | 307-265-2014
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Fax | 307-265-6696
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Provider Business Mailing Address
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Address Line | 111 S JEFFERSON ST STE 100
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City | CASPER
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State | WY
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Zip | 82601-2665
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Country | US
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Telephone | 307-265-2014
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Fax | 307-265-6696
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Authorized Official
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Title or Position | OWNER
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Name | MS. KARA LYNN MONPAS
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Credential |
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Telephone | 307-265-2014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | COTA-837
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License Number State | WY
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