Provider Demographics
NPI:1972187680
Name:TEAM THERAPY LLC
Entity Type:Organization
Organization Name:TEAM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OCCUPATIONAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATMON
Authorized Official - Suffix:
Authorized Official - Credentials:DOC/OTR
Authorized Official - Phone:678-777-8207
Mailing Address - Street 1:4208 REESHEMAH ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-1642
Mailing Address - Country:US
Mailing Address - Phone:678-777-8207
Mailing Address - Fax:770-456-5295
Practice Address - Street 1:4208 REESHEMAH ST
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-1642
Practice Address - Country:US
Practice Address - Phone:678-777-8207
Practice Address - Fax:770-456-5295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-09
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty