Provider Demographics
NPI:1487205738
Name:PROFESSIONAL OCCUPATIONAL THERAPY LLC
Entity Type:Organization
Organization Name:PROFESSIONAL OCCUPATIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUERGER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CLT
Authorized Official - Phone:417-763-8739
Mailing Address - Street 1:1355 W STONE HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-7093
Mailing Address - Country:US
Mailing Address - Phone:417-763-8739
Mailing Address - Fax:855-865-3942
Practice Address - Street 1:1355 W STONE HOUSE RD
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-7093
Practice Address - Country:US
Practice Address - Phone:417-763-8739
Practice Address - Fax:855-865-3942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty