Organization
FUNCTIONAL KIDS THERAPY CENTER LLC
Active
Organization
FUNCTIONAL KIDS THERAPY CENTER LLC
Active
Other names
Functional Kids
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CORTNEY A CARLISLE MS, OTR/L (OCCUPATIONAL THERAPIST)
(218) 929-9595
Entity
Organization
Contact information
Practice address
777 GOGUAC ST W STE B2, SPRINGFIELD, MI 49015-2097
(269) 832-8224
Mailing address
777 GOGUAC ST W STE B2, SPRINGFIELD, MI 49015-2097
(269) 832-8224
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
—
—
111N00000X
Chiropractor
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
12/31/2014
Last updated
09/02/2025
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