Provider Demographics
NPI:1740614270
Name:OT WORKS
Entity Type:Organization
Organization Name:OT WORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:KING
Authorized Official - Last Name:BUNTING
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:252-717-9668
Mailing Address - Street 1:2880 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6166
Mailing Address - Country:US
Mailing Address - Phone:252-717-9668
Mailing Address - Fax:
Practice Address - Street 1:2880 W 5TH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6166
Practice Address - Country:US
Practice Address - Phone:252-717-9668
Practice Address - Fax:252-321-0484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2627225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7349358Medicaid