Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
MITAN PEDIATRIC THERAPY INC
Active
Organization
MITAN PEDIATRIC THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN MITAN OT (OCCUPATIONAL THERAPIST)
(618) 806-8461
Entity
Organization
Contact information
Practice address
891 MEADOWVIEW LANE, COLUMBIA, IL 62236
(618) 806-8461
Mailing address
891 MEADOWVIEW LANE, COLUMBIA, IL 62236
(618) 806-8461
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2000155595
MO
225X00000X
Occupational Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06732018
BLUE CROSS BLUE SHIELD OF
—
01
—
7058311
AETNA
—
Enumeration date
10/16/2006
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers