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General NPI Number Information
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NPI Number | 1861670721
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Entity Type | Organization
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Legal Business Name | GREENTREE THERAPY LTD
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Dates
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Enumeration Date | 02/03/2008
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Last Update Date | 02/03/2008
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Provider Practice Location Address
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Address Line | 700 MAGNOLIA CIR SE
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City | NORTH CANTON
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State | OH
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Zip | 44709-1183
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Country | US
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Telephone | 330-494-2833
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Fax | 330-494-2840
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Provider Business Mailing Address
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Address Line | 700 MAGNOLIA CIR SE
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City | NORTH CANTON
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State | OH
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Zip | 44709-1183
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Country | US
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Telephone | 330-494-2833
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Fax | 330-494-2840
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Authorized Official
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Title or Position | OWNER
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Name | KAY M MALLOY
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Credential | PT
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Telephone | 330-494-2833
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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 | OT0003103
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT002925
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License Number State | OH
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