Basic Information
| Provider Information | |||||||||
| NPI: | 1346691250 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FUNCTION TO FUN THERAPY SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2233 E. MAIN ST. | ||||||||
| Address2: | BUSINESS OPTIONS MEDICAL BILLING | ||||||||
| City: | MONTROSE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 814013831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9707650818 | ||||||||
| FaxNumber: | 9704978410 | ||||||||
| Practice Location | |||||||||
| Address1: | 15658 6282 RD | ||||||||
| Address2: | |||||||||
| City: | MONTROSE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 814038468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9707650650 | ||||||||
| FaxNumber: | 9704447044 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2016 | ||||||||
| LastUpdateDate: | 06/22/2016 | ||||||||
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| AuthorizedOfficialLastName: | REDDIN | ||||||||
| AuthorizedOfficialFirstName: | KARI | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9707650650 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | OTR | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT.0004559 | CO | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.