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Organization

SOUTHEAST OT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RYAN JOHN SALMON OTR/L (OWNER/OCCUPATIONAL THERAPIST)
(907) 314-0081
Entity
Organization

Contact information

Practice address
206 PIEDAD ROAD, HAINES, AK 99827
(907) 314-0081
Mailing address
PO BOX 877, HAINES, AK 99827-0877
(907) 314-0081

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
01/15/2019
Last updated
03/06/2019
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