Provider Demographics
NPI:1760142632
Name:ROCK RIVER THERAPY PLLC
Entity Type:Organization
Organization Name:ROCK RIVER THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-222-0512
Mailing Address - Street 1:PO BOX 162
Mailing Address - Street 2:
Mailing Address - City:EAST DOVER
Mailing Address - State:VT
Mailing Address - Zip Code:05341-0162
Mailing Address - Country:US
Mailing Address - Phone:323-680-0586
Mailing Address - Fax:
Practice Address - Street 1:94 GOOSE CITY RD
Practice Address - Street 2:
Practice Address - City:EAST DOVER
Practice Address - State:VT
Practice Address - Zip Code:05341
Practice Address - Country:US
Practice Address - Phone:323-680-0586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-20
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty