Provider Demographics
NPI:1053160895
Name:ROOTS THERAPY SOLUTIONS, LLC
Entity type:Organization
Organization Name:ROOTS THERAPY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMNER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:660-281-6179
Mailing Address - Street 1:473 DRY RIVER CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803-4571
Mailing Address - Country:US
Mailing Address - Phone:417-744-9094
Mailing Address - Fax:417-290-2166
Practice Address - Street 1:473 DRY RIVER CT
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-4571
Practice Address - Country:US
Practice Address - Phone:417-744-9094
Practice Address - Fax:417-290-2166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty