Organization
TRIPLE E OT INC
Active
Organization
TRIPLE E OT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM EVELYN HYDLE OTR/L (OCCUPATIONAL THERAPIST)
(850) 401-1227
Entity
Organization
Contact information
Practice address
4100 S FERDON BLVD, SUITE C1, CRESTVIEW, FL 32536-5252
(850) 682-8388
(850) 682-7463
Mailing address
450 LAKEVIEW DR, DEFUNIAK SPRINGS, FL 32433-4058
(850) 401-1227
(850) 682-7463
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT5156
FL
Other
Enumeration date
06/01/2011
Last updated
06/01/2011
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