Organization
OUTSIDE THE BOX THERAPY, LLC
Active
Other names
Outside The Box Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JARED CORDUM (MEMBER)
(217) 415-0855
Entity
Organization
Contact information
Practice address
3009 N PRINCE ST # 46, CLOVIS, NM 88101-3818
(217) 415-0855
Mailing address
PO BOX 5751, CLOVIS, NM 88102-5751
(217) 415-0855
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
06/04/2022
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