Organization
WASHINGTON OCCUPATIONAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN PATRICK VANSTAALDUINEN (ORGANIZER)
(252) 402-9546
Entity
Organization
Contact information
Practice address
611 E 12TH ST, WASHINGTON, NC 27889-3408
(252) 944-3410
Mailing address
755 BREEZY SHORE RD, BATH, NC 27808-9598
(252) 402-9546
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871075424
NPI
NC
Enumeration date
10/26/2023
Last updated
10/26/2023
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