Mitan Pediatric Therapy INC

NPI #1184704900 in Columbia, Illinois

Provider Information

NPI Number: 1184704900
Entity Type: Organization
Organization Name: Mitan Pediatric Therapy INC
Primary Specialty: Occupational Therapist
Enumeration Date: Oct 16, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 891 MEADOWVIEW LANE
City: Columbia
State: Illinois
ZIP Code: 62236
Phone: (618) 806-8461

Authorized Official

Name: ROBIN MITAN, OT
Title: OCCUPATIONAL THERAPIST
Phone: (618) 806-8461

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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