Organization
PROSPERITY THERAPY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY FERGUSON MOT, OTR/L (OCCUPATIONAL THERAPIST/PRESIDENT)
(918) 697-2909
Entity
Organization
Contact information
Practice address
41116 E COUNTY ROAD 1240, KEOTA, OK 74941-6451
(918) 697-2909
Mailing address
41116 E COUNTY ROAD 1240, KEOTA, OK 74941-6451
(918) 697-2909
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1904
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200554810A
—
OK
Enumeration date
08/21/2018
Last updated
08/21/2018
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