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General NPI Number Information
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NPI Number | 1316073422
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Entity Type | Organization
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Legal Business Name | PEDIATRIC THERAPY SERVICES, INC.
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Dates
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Enumeration Date | 02/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2712 KIVETT DR
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City | GREENSBORO
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State | NC
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Zip | 27407-9744
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Country | US
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Telephone | 336-852-4865
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Fax | 336-852-5413
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Provider Business Mailing Address
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Address Line | 2712 KIVETT DR
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City | GREENSBORO
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State | NC
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Zip | 27407-9744
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Country | US
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Telephone | 336-852-4865
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Fax | 336-852-5413
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. REBECCA MURRELL MATTOCKS
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Credential | PT
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Telephone | 336-852-4865
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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 | 1227
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License Number State | NC
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