Organization
THERAPY MADE FUN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LAGENA KAY IMMEL OTR (OCCUPATIONAL THERAPIST)
(479) 754-2107
Entity
Organization
Contact information
Practice address
1000 W BUCHANAN ST, CLARKSVILLE, AR 72830-2252
(479) 754-6210
Mailing address
PO BOX 1622, CLARKSVILLE, AR 72830-1622
(479) 754-2107
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OTR1512
AR
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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