| Pediatric Therapies Of Se Ga, Llc | |
|
1204 Hospitality Ave, Suite E, Kingsland, GA 31548-6810 | |
| (912) 996-2069 | |
| (912) 265-0041 |
| Full Name | Pediatric Therapies Of Se Ga, Llc |
|---|---|
| Type | Facility |
| Speciality | Occupational Therapist - Pediatrics |
| Location | 1204 Hospitality Ave, Kingsland, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710346267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225XP0200X | Occupational Therapist - Pediatrics | OT001375 (Georgia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Therapies Of Se Ga, Llc 5200 San Jose Blvd, Unit 7, Jacksonville, FL 32207-1905 Ph: (912) 996-2069 | Pediatric Therapies Of Se Ga, Llc 1204 Hospitality Ave, Suite E, Kingsland, GA 31548-6810 Ph: (912) 996-2069 |
Erica M Boyd, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Lindsey Ln, B, Kingsland, GA 31548 Phone: 912-510-6104 Fax: 912-882-6137 | |
Philusa Chua Mcbroom, OTDR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 100b Lindsey Lane, Kingsland, GA 31548 Phone: 912-510-6104 Fax: 912-882-6137 | |
Rachel Valerie Lane, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Lindsey Ln, Suite B, Kingsland, GA 31548 Phone: 912-510-6104 Fax: 912-882-6137 | |
Mary Delage, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 130 N Gross Rd Ste 125, Kingsland, GA 31548 Phone: 912-342-8875 Fax: 912-265-0041 | |
Jenna Price, MOT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1204 Hospitality Ave Ste E, Kingsland, GA 31548 Phone: 912-996-2069 Fax: 912-265-0041 | |
Shamekia Louise Louis, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Lindsey Ln, Suite B, Kingsland, GA 31548 Phone: 912-510-6104 Fax: 912-882-6137 | |
Genevieve Matherne, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 100b Lindsey Lane, Kingsland, GA 31548 Phone: 912-510-6104 Fax: 912-882-6137 |