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NPI Code Detail

MEDICARE: INFANT CONNECTIONS, LLC

MEDICARE: INFANT CONNECTIONS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT004893GA
2235Z00000XSpeech-Language PathologistSLP006507GA
3225100000XPhysical TherapistPT009158GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174956924
Entity Type Code : Organization
Provider Name (Legal Business Name) : INFANT CONNECTIONS, LLC
Provider Business Mailing Address
First Line : 1631 RICHWOOD DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30319-3605
Country : US
Telephone Number : 678-386-4395
Fax Number : 678-281-1796
Provider Business Practice Location Address
First Line : 1631 RICHWOOD DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30319-3605
Country : US
Telephone Number : 678-386-4395
Fax Number : 678-281-1796
Authorized Official
Title or Position : OWNER
Name : BRITTANY JENNINGS
Credential : PT, DPT
Telephone Number : 678-386-4395
Provider Enumeration Date : 08/15/2013
Last Update Date : 08/15/2013

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Directions to “INFANT CONNECTIONS, LLC ” Practice Location

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