Provider Demographics
NPI:1174246417
Name:MILLSTONE THERAPY GROUP LLC
Entity type:Organization
Organization Name:MILLSTONE THERAPY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:CLINE
Authorized Official - Last Name:LAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-228-5444
Mailing Address - Street 1:8452 HESSIAN HILL CT
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-1166
Mailing Address - Country:US
Mailing Address - Phone:304-228-5444
Mailing Address - Fax:
Practice Address - Street 1:8452 HESSIAN HILL CT
Practice Address - Street 2:
Practice Address - City:BRISTOW
Practice Address - State:VA
Practice Address - Zip Code:20136-1166
Practice Address - Country:US
Practice Address - Phone:304-228-5444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty