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General NPI Number Information
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NPI Number | 1699073932
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Entity Type | Organization
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Legal Business Name | PLAY BALL CHILDREN'S THERAPY, LLC
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 04/25/2014
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Provider Practice Location Address
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Address Line | 125 ISLAND DR
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-4544
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Country | US
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Telephone | 615-714-9224
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Fax |
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Provider Business Mailing Address
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Address Line | 125 ISLAND DR
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-4544
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Country | US
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Telephone | 615-714-9224
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANDREA WATSON BALL
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Credential | OTR/L
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Telephone | 615-714-9224
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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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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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