Organization
MISSOULA PEDIATRIC THERAPY CENTER INC
Active
Other names
Kidzoola Therapy Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAMON SIMMONS OTR/L (PRESIDENT)
(312) 404-4578
Entity
Organization
Contact information
Practice address
2321 S 3RD ST W, MISSOULA, MT 59801-1332
(406) 214-3131
Mailing address
2321 S 3RD ST W, MISSOULA, MT 59801-1332
(406) 214-3131
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
Primary
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/06/2018
Last updated
09/28/2021
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