Organization
OTHER SIDE OF PLAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY TUELL (OWNER)
(850) 294-4666
Entity
Organization
Contact information
Practice address
1454 HORSESHOE COVE RD, WAVERLY, GA 31565-2110
(850) 294-4666
Mailing address
PO BOX 5211, SAINT MARYS, GA 31558-5211
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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