Provider Demographics
NPI:1679182968
Name:CAN DO KIDS PEDIATRIC THERAPY SERVICES
Entity Type:Organization
Organization Name:CAN DO KIDS PEDIATRIC THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:LOTR
Authorized Official - Phone:618-599-2295
Mailing Address - Street 1:613 SIMPSON ST
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006-8314
Mailing Address - Country:US
Mailing Address - Phone:618-599-2295
Mailing Address - Fax:
Practice Address - Street 1:613 SIMPSON ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:LA
Practice Address - Zip Code:71006-8314
Practice Address - Country:US
Practice Address - Phone:618-599-2295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty