Provider Demographics
NPI:1407371271
Name:PEDIATRIC THERAPY SOLUTIONS LLC
Entity Type:Organization
Organization Name:PEDIATRIC THERAPY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-841-3574
Mailing Address - Street 1:2500 SHALLOWFORD RD NE APT 6302
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-1236
Mailing Address - Country:US
Mailing Address - Phone:770-841-3574
Mailing Address - Fax:
Practice Address - Street 1:2500 SHALLOWFORD RD NE APT 6302
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-1236
Practice Address - Country:US
Practice Address - Phone:770-841-3574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech