MEDICARE: TAILORED OCCUPATIONAL THERAPY 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
1	261QD1600X	Developmental Disabilities Clinic/Center
2	261QP2000X	Physical Therapy Clinic/Center
3	174400000X	Specialist	OT001309	GA

Other Identifiers

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

General Provider Information

NPI Number	:	1265500243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAILORED OCCUPATIONAL THERAPY LLC

Provider Business Mailing Address
First Line	:	PO BOX 943
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30168-1053
Country	:	US
Telephone Number	:	678-637-7812
Fax Number	:	678-922-1515

Provider Business Practice Location Address
First Line	:	351 THORNTON RD STE 125
Second Line	:
City	:	LITHIA SPRINGS
State	:	GA
Zip	:	30122-1589
Country	:	US
Telephone Number	:	770-577-0399
Fax Number	:	678-922-1515

Authorized Official
Title or Position	:	CEO
Name	:	DANA L HARRIS
Credential	:	OT
Telephone Number	:	678-637-7812

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	03/11/2021

Similar Medicare Providers

1528992666 — SPECTRUM HEALTH SERVICES
Practice Location Address:

351 THORNTON RD STE 119
LITHIA SPRINGS, GA
30122-1589

Practice Phone: 678-464-3078
Practice Fax:

1184201782 — TYRISA BURDINE SPECIALIST
Practice Location Address:

351 THORNTON RD STE 118
LITHIA SPRINGS, GA
30122-1589

Practice Phone: 865-455-8410
Practice Fax:

1003489048 — KEISY ARISLU LOPEZ-LOMELI OTD
Practice Location Address:

351 THORNTON RD STE 125
LITHIA SPRINGS, GA
30122-1589

Practice Phone: 770-577-0399
Practice Fax:

1154069391 — BENTWATER COSMETIC AND FAMILY DENTISTRY
Practice Location Address:

351 THORNTON RD STE 101
LITHIA SPRINGS, GA
30122-1589

Practice Phone: 770-944-9755
Practice Fax: 770-944-1261

1053033548 — MIRIAH SMITH DPT
Practice Location Address:

351 THORNTON RD STE 125
LITHIA SPRINGS, GA
30122-1589

Practice Phone: 770-577-0399
Practice Fax:

1174215727 — LITHIA SPRINGS COSMETIC AND FAMILY DENTISTRY P.C.
Practice Location Address:

351 THORNTON RD STE 101
LITHIA SPRINGS, GA
30122-1589

Practice Phone: 770-944-9755
Practice Fax: 770-944-1261

Directions to “TAILORED OCCUPATIONAL THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.