Provider Demographics
NPI:1235736547
Name:THE PLAY HUT PLLC
Entity Type:Organization
Organization Name:THE PLAY HUT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:276-591-9922
Mailing Address - Street 1:2696 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:VA
Mailing Address - Zip Code:24266-6526
Mailing Address - Country:US
Mailing Address - Phone:276-591-9922
Mailing Address - Fax:
Practice Address - Street 1:635 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266-3809
Practice Address - Country:US
Practice Address - Phone:276-591-9922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty