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NPI Code Detail

MEDICARE: PRIMROSE PEDIATRIC THERAPY, LLC

MEDICARE: PRIMROSE PEDIATRIC 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
1224Z00000XOccupational Therapy Assistant
2225100000XPhysical Therapist
3225200000XPhysical Therapy Assistant
4225X00000XOccupational Therapist
5235Z00000XSpeech-Language Pathologist
6261QR0400XRehabilitation Clinic/Center

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 : 1932787835
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIMROSE PEDIATRIC THERAPY, LLC
Provider Business Mailing Address
First Line : 430 S LAKE ST
Second Line :
City : PARIS
State : TN
Zip : 38242-4573
Country : US
Telephone Number : 731-336-7352
Fax Number : 731-407-7277
Provider Business Practice Location Address
First Line : 430 S LAKE ST
Second Line :
City : PARIS
State : TN
Zip : 38242-4573
Country : US
Telephone Number : 731-336-7352
Fax Number : 731-407-7277
Authorized Official
Title or Position : OCCUPATIONAL THERAPIST
Name : MRS. LINDLEY PRIMROSE
Credential :
Telephone Number : 731-336-7352
Provider Enumeration Date : 03/31/2021
Last Update Date : 01/03/2023

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Directions to “PRIMROSE PEDIATRIC THERAPY, LLC ” Practice Location

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