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General NPI Number Information
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NPI Number | 1548302680
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Entity Type | Organization
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Legal Business Name | PEDIATRIC THERAPY SERVICES LLC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 1031 OAK ST
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City | MONTGOMERY
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State | AL
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Zip | 36108-2829
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Country | US
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Telephone | 334-264-8988
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9496
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City | MONTGOMERY
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State | AL
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Zip | 36108-0010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. DANITA JOHNSON
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Credential |
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Telephone | 33426489788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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