Peach State Pediatric Therapy Inc. in Lawrenceville - Specialist
Peach State Pediatric Therapy Inc. - NPI 1073630992
Peach State Pediatric Therapy Inc. is a Specialist in Lawrenceville, Georgia. Peach State Pediatric Therapy Inc. practices all healthcare services and medical treatments related to Specialist. The NPI Number for Peach State Pediatric Therapy Inc. is 1073630992. The last update date is 2020-08-22.
Peach State Pediatric Therapy Inc.'s current location address is 457 Autumn Park Trce, Lawrenceville, Georgia. You can contact this provider via phone number 6785243451 and fax number 7709217380. The mailing address for Peach State Pediatric Therapy Inc. is 457 Autumn Park Trce, Lawrenceville, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Peach State Pediatric Therapy Inc. |
|---|---|
| Address | 457 Autumn Park Trce, Lawrenceville, Georgia |
| Phone Number | 6785243451 |
| Fax Number | 7709217380 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Kuneyl Ann Margaret |
| Credentials | OT |
| Telephone Number | 6785243451 |
NPI Number Detail
| NPI Number | 1073630992 |
|---|---|
| Provider Enumeration Date | 2007-03-24 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 457 Autumn Park Trce |
|---|---|
| City | Lawrenceville |
| State | Georgia (GA) |
| Post Code | 300447421 |
| Phone Number | 6785243451 |
| Fax Number | 7709217380 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | OT002948 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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What is the unique 10-digit identifier code assigned to Peach State Pediatric Therapy Inc. by the Centers for Medicare & Medicaid Services?
The Peach State Pediatric Therapy Inc. has been issued the NPI (National Provider Identifier) 1073630992 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Peach State Pediatric Therapy Inc. located?
The Peach State Pediatric Therapy Inc. is located at 457 Autumn Park Trce, Lawrenceville, GA 300447421.
What is Peach State Pediatric Therapy Inc.'s primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Peach State Pediatric Therapy Inc. is Specialist, and the taxonomy classification code that categorizes this area of expertise is 174400000X.
On what date was the 1073630992 assigned to Peach State Pediatric Therapy Inc.?
The Peach State Pediatric Therapy Inc. was issued its 1073630992 on 2007-03-24, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Peach State Pediatric Therapy Inc. most recently updated or revised?
The information pertaining to Peach State Pediatric Therapy Inc., including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.
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