Provider Demographics
NPI:1578622593
Name:ATLANTA PEDIATRIC THERAPY, INC.
Entity Type:Organization
Organization Name:ATLANTA PEDIATRIC THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-575-4000
Mailing Address - Street 1:4961 BUFORD HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-3535
Mailing Address - Country:US
Mailing Address - Phone:404-575-4000
Mailing Address - Fax:404-575-4010
Practice Address - Street 1:4961 BUFORD HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-3535
Practice Address - Country:US
Practice Address - Phone:404-575-4000
Practice Address - Fax:404-575-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency