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General NPI Number Information
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NPI Number | 1801311345
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Entity Type | Organization
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Legal Business Name | KINGDOM THERAPY SERVICES LLC
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Dates
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Enumeration Date | 08/05/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 4434 GEARHART RD APT 2901
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City | TALLAHASSEE
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State | FL
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Zip | 32303-2499
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Country | US
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Telephone | 850-274-4908
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Fax |
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Provider Business Mailing Address
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Address Line | 4434 GEARHART RD APT 2901
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City | TALLAHASSEE
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State | FL
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Zip | 32303-2499
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Country | US
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Telephone | 850-274-4908
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/OWENER
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Name | MRS. ADRIANNE SMILEY GURLEY
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Credential |
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Telephone | 678-492-6237
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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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