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General NPI Number Information
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NPI Number | 1972865889
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Entity Type | Organization
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Legal Business Name | AMERICAN THERAPY HOUSE
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 06/15/2012
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Provider Practice Location Address
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Address Line | 601 NW 96TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6232
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Country | US
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Telephone | 954-608-9930
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Fax | 954-241-6726
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Provider Business Mailing Address
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Address Line | 601 NW 96TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6232
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Country | US
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Telephone | 954-608-9930
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Fax | 954-241-6726
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MISS HEATHER LYN RETSKE
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Credential | OT
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Telephone | 954-608-9930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | OT9537
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License Number State | FL
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