Organization
PEDIATRIC THERAPY PROFESSIONALS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERILYN JEAN AMAN OTRL (THERAPY COORDINATOR)
(541) 368-4313
Entity
Organization
Contact information
Practice address
111 NE 20TH ST, PHILOMATH, OR 97370
(541) 368-4313
(541) 929-4967
Mailing address
PO BOX 455, PHILOMATH, OR 97370
(541) 368-4313
(541) 929-4967
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247405
—
OR
Enumeration date
03/22/2007
Last updated
09/30/2008
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