Organization
LEAP FORWARD OT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN WITWER MOT (OWNER)
(937) 572-0873
Entity
Organization
Contact information
Practice address
852 CEDAR GROVE DR, TIPP CITY, OH 45371-7587
(937) 572-0873
Mailing address
852 CEDAR GROVE DR, TIPP CITY, OH 45371-7587
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
11/08/2024
Last updated
11/19/2024
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