Provider Demographics
NPI:1063837722
Name:BEYOND LIMITS PEDIATRIC THERAPY CENTER
Entity Type:Organization
Organization Name:BEYOND LIMITS PEDIATRIC THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:OVIEDO
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:678-907-1843
Mailing Address - Street 1:3950 COBB PKWY NW
Mailing Address - Street 2:SUITE 801
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-9532
Mailing Address - Country:US
Mailing Address - Phone:678-907-1843
Mailing Address - Fax:678-354-6786
Practice Address - Street 1:3950 COBB PKWY NW
Practice Address - Street 2:SUITE 801
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-9532
Practice Address - Country:US
Practice Address - Phone:678-907-1843
Practice Address - Fax:678-354-6786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224Z00000X, 225100000X, 235Z00000X
GAOT005495225X00000X
GA003201231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty