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General NPI Number Information
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NPI Number | 1174041354
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Entity Type | Organization
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Legal Business Name | PEDIATRIC THERAPY SOLUTIONS, LLC
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3131 PRINCETON PIKE STE 100
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2201
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Country | US
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Telephone | 609-213-6439
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Fax |
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Provider Business Mailing Address
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Address Line | 3131 PRINCETON PIKE BUILDING 4 SUITE 100
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648
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Country | US
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Telephone | 609-213-6439
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Fax |
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | MRS. MICHELLE JOY DAVIS-KORNGUT
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Credential | MS OTR/L
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Telephone | 609-213-6439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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