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Organization
LEGACY THERAPEUTIC SERVICES, INC.
Active
Organization
LEGACY THERAPEUTIC SERVICES, INC.
Active
Parent organization
THE CHILDREN'S CLINIC
Other names
The Children's Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE CHILDREN'S CLINIC
Authorized official
MR. MATTHEW EDWARD OSBOURN OTR/L (OCCUPATIONAL THERAPIST)
(423) 762-8846
Entity
Organization
Contact information
Practice address
18270 SISKIYOU RD STE B, APPLE VALLEY, CA 92307-1413
(760) 991-3020
Mailing address
18270 SISKIYOU RD STE B, APPLE VALLEY, CA 92307-1413
(760) 991-3020
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033619580
MATTHEW OSBOURN NPI
—
Enumeration date
12/01/2022
Last updated
12/01/2022
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