Provider Demographics
NPI:1710632948
Name:OVERTIME THERAPY INC
Entity Type:Organization
Organization Name:OVERTIME THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORDYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRILL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:479-200-6026
Mailing Address - Street 1:1716 W CUNNINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8414
Mailing Address - Country:US
Mailing Address - Phone:479-200-6026
Mailing Address - Fax:
Practice Address - Street 1:1716 W CUNNINGHAM AVE
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8414
Practice Address - Country:US
Practice Address - Phone:479-200-6026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty