# BOUNCE THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255021424
- **Authorized official:** ALICIA CLARK OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (435) 655-1210

## Contact information

- **Practice address:** 6318 VIEW DR, PARK CITY, UT 84098-6156
- **Practice address phone:** (435) 655-1210
- **Mailing address:** 6318 VIEW DR, PARK CITY, UT 84098-6156
- **Mailing address phone:** (435) 655-1210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225XE0001X | Environmental Modification Occupational Therapist | — | NULL | — |
| 225XE0001X | Environmental Modification Occupational Therapist | — | — | — |
| 225XE1200X | Ergonomics Occupational Therapist | — | NULL | — |
| 225XE1200X | Ergonomics Occupational Therapist | — | — | — |
| 225XF0002X | Feeding, Eating & Swallowing Occupational Therapist | — | NULL | — |
| 225XF0002X | Feeding, Eating & Swallowing Occupational Therapist | — | — | — |
| 225XG0600X | Gerontology Occupational Therapist | — | NULL | — |
| 225XG0600X | Gerontology Occupational Therapist | — | — | — |
| 225XL0004X | Low Vision Occupational Therapist | — | NULL | — |
| 225XL0004X | Low Vision Occupational Therapist | — | — | — |
| 225XM0800X | Mental Health Occupational Therapist | — | NULL | — |
| 225XM0800X | Mental Health Occupational Therapist | — | — | — |
| 225XN1300X | Neurorehabilitation Occupational Therapist | — | NULL | — |
| 225XN1300X | Neurorehabilitation Occupational Therapist | — | — | — |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | — | NULL | Yes |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | — | — | Yes |
| 225XP0200X | Pediatric Occupational Therapist | — | NULL | — |
| 225XP0200X | Pediatric Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 05/11/2023
- **Last updated:** 06/27/2023