| Blue Tide Pediatric Therapy Llc | |
|
4641 Gulfstarr Dr Ste 102 Destin FL 32541-3776 | |
| (850) 964-6162 | |
| (850) 848-6643 |
| Full Name | Blue Tide Pediatric Therapy Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 4641 Gulfstarr Dr Ste 102, Destin, Florida |
| Authorized Official Name and Position | Garrett Outland (OWNER/SPEECH-LANGUAGE PATHOLOGIST) |
| Authorized Official Contact | 8509646162 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Tide Pediatric Therapy Llc 4641 Gulfstarr Dr Ste 102 Destin FL 32541-3776 Ph: () - | Blue Tide Pediatric Therapy Llc 4641 Gulfstarr Dr Ste 102 Destin FL 32541-3776 Ph: (850) 964-6162 |
| NPI Number | 1114654431 |
|---|---|
| Provider Enumeration Date | 08/05/2022 |
| Last Update Date | 01/13/2025 |
| Certification Date | 01/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114654431 | NPI | - | NPPES |
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