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Organization

ASHLEY GRAHAM, OTR/L LLC

Active
Other names
GO Therapy LLC
Organization subpart
No

Provider details

NPI number
Authorized official
ASHLEY GRAHAM (OCCUPATIONAL THERAPIST)
(405) 501-1547
Entity
Organization

Contact information

Practice address
2506 DIFFEE DR, TAHLEQUAH, OK 74464-5721
(405) 501-1547
Mailing address
2506 DIFFEE DR, TAHLEQUAH, OK 74464-5721
(405) 501-1547

Taxonomy

Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
03/18/2020
Last updated
02/25/2021
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