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General NPI Number Information
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NPI Number | 1104691260
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Entity Type | Organization
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Legal Business Name | LITTLE SPROUTS BUDDING FUTURES PEDIATRIC THERAPY L.L.C.
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 9111 CEDAR RIVER RD
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-7845
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Country | US
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Telephone | 407-864-5635
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Fax |
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Provider Business Mailing Address
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Address Line | 9111 CEDAR RIVER RD
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-7845
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Country | US
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Telephone | 407-864-5635
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/OCCUPATIONAL THERAPIST
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Name | MS. BROOKE GROGAN
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Credential | OTR/L
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Telephone | 949-701-5765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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