Provider Demographics
NPI:1164744629
Name:PEDIATRIC THERAPY PARTNERS LLC
Entity Type:Organization
Organization Name:PEDIATRIC THERAPY PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BORN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:614-433-0132
Mailing Address - Street 1:640 ENTERPRISE DR STE C
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-9440
Mailing Address - Country:US
Mailing Address - Phone:614-433-0132
Mailing Address - Fax:
Practice Address - Street 1:640 ENTERPRISE DR STE C
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-9440
Practice Address - Country:US
Practice Address - Phone:614-433-0132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH004745225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty