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General NPI Number Information
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NPI Number | 1770144594
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Entity Type | Organization
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Legal Business Name | FOUNDATIONS PEDIATRIC THERAPY
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 06/24/2019
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Provider Practice Location Address
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Address Line | 118 ADRIS PL
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City | DOTHAN
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State | AL
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Zip | 36303-1997
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Country | US
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Telephone | 334-677-6360
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Fax |
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Provider Business Mailing Address
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Address Line | 324 POWDER HORN DR
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City | MIDLAND CITY
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State | AL
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Zip | 36350-7024
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Country | US
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Telephone | 334-313-4844
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/CEO
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Name | KRISTIN BARNES HELMS
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Credential | OTD
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Telephone | 334-313-4844
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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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