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General NPI Number Information
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NPI Number | 1457892143
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Entity Type | Organization
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Legal Business Name | CREATIVE OT SOLUTIONS, LLC
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 01/29/2018
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Provider Practice Location Address
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Address Line | 6190 OLD FRANCONIA RD STE A
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City | ALEXANDRIA
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State | VA
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Zip | 22310-2593
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Country | US
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Telephone | 571-245-6985
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Fax |
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Provider Business Mailing Address
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Address Line | 6190 OLD FRANCONIA RD STE A
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City | ALEXANDRIA
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State | VA
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Zip | 22310-2593
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Country | US
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Telephone | 571-245-6985
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. PAMELA A SLEDGE
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Credential | OTR/L
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Telephone | 571-245-6985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number | 17-CREA
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License Number State | VA
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