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General NPI Number Information
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NPI Number | 1881973410
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Entity Type | Individual
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Provider Name | KYRI VANVOORST MOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/13/2011
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 14775 W YORKSHIRE DR
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City | SURPRISE
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State | AZ
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Zip | 85374-7224
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Country | US
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Telephone | 623-377-9698
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Fax |
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Provider Business Mailing Address
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Address Line | 28425 N BLACK CANYON HWY #3081
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City | PHOENIX
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State | AZ
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Zip | 85085-7601
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Country | US
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Telephone | 712-540-8633
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4833
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License Number State | AZ
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