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Organization
TRIPLE E OT, INC
Active
Organization
TRIPLE E OT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM E HYDLE OTR/L (OCCUPATIONAL THERAPIST/DIRECTOR)
(850) 682-8388
Entity
Organization
Contact information
Practice address
450 LAKEVIEW DR, DEFUNIAK SPRINGS, FL 32433-4058
(850) 401-1227
(850) 892-6994
Mailing address
4100 S FERDON BLVD, SUITE C-1, CRESTVIEW, FL 32536-5252
(850) 682-8388
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT5156
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000124300
—
FL
Enumeration date
09/13/2010
Last updated
09/13/2010
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