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Organization

PLAY WELL PEDIATRIC THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KIMBERLY KAY PETERSON MOT, OTR/L (PEDIATRIC OCCUPATIONAL THERAPIST)
(309) 846-6664
Entity
Organization

Contact information

Practice address
804 DALLAS RD, WASHINGTON, IL 61571-9230
(309) 846-6664
Mailing address
804 DALLAS RD, WASHINGTON, IL 61571-9230
(309) 846-6664

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.009667
IL

Other

Enumeration date
10/13/2015
Last updated
10/13/2015
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