Organization
THERAPLAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY JAMES RUTLAND II OTR/L (OWNER)
(678) 761-2863
Entity
Organization
Contact information
Practice address
1401 TIFT AVE N STE B, TIFTON, GA 31794-3577
(229) 396-5644
(855) 565-1769
Mailing address
96232 RIDGEWOOD CIR, FERNANDINA BEACH, FL 32034-8160
(678) 761-2863
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003261217A
—
GA
Enumeration date
08/23/2021
Last updated
10/12/2022
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