Organization
CANYON KIDS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED RICKS MOT, OTR (OWNER/OCCUPATIONAL THERAPIST)
(208) 360-9969
Entity
Organization
Contact information
Practice address
9502 NOVACEK BLVD, SAN ANTONIO, TX 78254-2121
(208) 360-9969
Mailing address
9502 NOVACEK BLVD, SAN ANTONIO, TX 78254-2121
(208) 360-9969
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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