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Organization

123OT, LLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STACI LEDET (COTA)
(260) 243-1198
Entity
Organization

Contact information

Practice address
10335 CORYDON CT, INDIANAPOLIS, IN 46239-9781
(317) 437-0848
Mailing address
10335 CORYDON CT, INDIANAPOLIS, IN 46239-9781

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
02/09/2020
Last updated
02/09/2020
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