Organization
ALL STAR THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIAN REY GRAN (OWNER)
(732) 983-1178
Entity
Organization
Contact information
Practice address
1112 W 4175 S, RIVERDALE, UT 84405-2633
(732) 983-1178
Mailing address
1112 W 4175 S, RIVERDALE, UT 84405-2633
(732) 983-1178
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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