Organization
SPROUTS PEDIATRIC CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KILEY THROOP MS, OTR/L (OCCUPATIONAL THERAPIST / OWNER)
(206) 653-6090
Entity
Organization
Contact information
Practice address
200 VALENCIA DR STE 160, JACKSONVILLE, NC 28546-6315
(206) 653-6090
Mailing address
301 LONDON BERRY LN, JACKSONVILLE, NC 28540-4243
(206) 653-6090
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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