| Black's Pediatric Therapy, Inc. | |
|
4502 Summer Gate Ct., Gainesville, GA 30506 | |
| (770) 378-5986 | |
| Not Available |
| Full Name | Black's Pediatric Therapy, Inc. |
|---|---|
| Type | Facility |
| Speciality | Occupational Therapist - Pediatrics |
| Location | 4502 Summer Gate Ct., Gainesville, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477754067 | NPI | - | NPPES |
| 10038361 | Other | GA | AMERIGROUP- TINA |
| 307327 | Other | GA | TINA- WELLCARE |
| 10047944 | Other | GA | AMERIGROUP-BETH CHAMBERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225XP0200X | Occupational Therapist - Pediatrics | 003199 (Georgia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Black's Pediatric Therapy, Inc. 4502 Summer Gate Ct., Gainesville, GA 30506 Ph: (770) 378-5986 | Black's Pediatric Therapy, Inc. 4502 Summer Gate Ct., Gainesville, GA 30506 Ph: (770) 378-5986 |
Krisi April Probert, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 655 Jesse Jewell Pkwy Se, Suite C, Gainesville, GA 30501 Phone: 770-539-9001 Fax: 770-539-9217 | |
Tina Marie Black, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4502 Summer Gate Ct, Gainesville, GA 30506 Phone: 770-378-5986 Fax: 770-536-0346 | |
Christa Perry Tullis, O.T. Occupational Therapist Medicare: Medicare Enrolled Practice Location: 100 Spring St, Suite B, Gainesville, GA 30501 Phone: 770-532-5721 Fax: 770-532-5929 | |
Shannon Randall, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2030 Windward Ln, Gainesville, GA 30501 Phone: 770-535-8181 | |
Brianna Lynn Brown, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 428 S Enota Dr Ne, Gainesville, GA 30501 Phone: 678-865-4947 | |
Mr. Myron Westley Green, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 955 Interstate Ridge Dr Unit E, Gainesville, GA 30501 Phone: 678-936-8695 | |
Charlie Turk Chapman, OTR/L, CPAM Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2360 Murphy Blvd, Gainesville, GA 30504 Phone: 770-535-8372 |