Organization
SUNDANCE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY P GALLOWAY OTR (OCCUPATIONAL THERAPIST/ OWNER)
(601) 493-6968
Entity
Organization
Contact information
Practice address
2088 WOODPECKER LN, ELIZABETH, CO 80107-8558
(601) 493-6968
Mailing address
2088 WOODPECKER LN, ELIZABETH, CO 80107-8558
(601) 493-6968
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA.0000647
CO
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OT.0000937
CO
Other
Enumeration date
12/16/2016
Last updated
11/15/2021
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