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General NPI Number Information
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NPI Number | 1417904947
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Entity Type | Organization
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Legal Business Name | MCKENNA FARMS THERAPY SERVICES INC
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Dates
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Enumeration Date | 05/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3044 DUE WEST RD
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City | DALLAS
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State | GA
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Zip | 30157-2125
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Country | US
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Telephone | 770-443-9672
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Fax | 770-505-3595
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Provider Business Mailing Address
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Address Line | 3044 DUE WEST RD
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City | DALLAS
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State | GA
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Zip | 30157-2125
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Country | US
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Telephone | 770-443-9672
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Fax | 770-505-3595
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | CHERYL ZIEGLER
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Credential |
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Telephone | 770-432-8996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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