Provider Demographics
NPI:1831809532
Name:OT ON THE GO, LLC
Entity type:Organization
Organization Name:OT ON THE GO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:BERTINE
Authorized Official - Last Name:HIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:540-204-1099
Mailing Address - Street 1:6262 MEACHAM RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-8258
Mailing Address - Country:US
Mailing Address - Phone:540-204-1099
Mailing Address - Fax:540-264-3010
Practice Address - Street 1:6262 MEACHAM RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-8258
Practice Address - Country:US
Practice Address - Phone:540-204-1099
Practice Address - Fax:540-264-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty