Organization
OTA THE KOOMAR CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAYLOR DAVIDSON (CEO)
(617) 999-9585
Entity
Organization
Contact information
Practice address
74 BRIDGE ST, NEWTON, MA 02458-1147
(617) 969-4410
Mailing address
15245 SHADY GROVE RD STE 110, ROCKVILLE, MD 20850-7202
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
03/01/2021
Last updated
03/01/2021
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