Organization
SPROUT THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA REISHUS DAVIDSON OTR/L (OCCUPATIONAL THERAPIST/OWNER)
(218) 371-6647
Entity
Organization
Contact information
Practice address
50438 W LAKE SEVEN RD, FRAZEE, MN 56544-8919
(218) 234-2094
(888) 892-2924
Mailing address
PO BOX 193, VERGAS, MN 56587-0193
(218) 234-2094
(888) 892-2924
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
06/19/2023
Last updated
03/04/2024
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