# KOOL KIDZ INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134386337
- **Authorized official:** JEFF WENTZ (BUSINESS MANAGER)
- **Authorized official phone:** (770) 517-2480

## Contact information

- **Practice address:** 2465 CANOPY GLN, MARIETTA, GA 30066-1541
- **Practice address phone:** (770) 517-2480
- **Practice address fax:** (770) 592-9431
- **Mailing address:** 2465 CANOPY GLN, MARIETTA, GA 30066-1541
- **Mailing address phone:** (770) 517-2480
- **Mailing address fax:** (770) 592-9431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | GA | — |
| 2251P0200X | Pediatric Physical Therapist | — | GA | Yes |
| 225X00000X | Occupational Therapist | — | GA | — |
| 225XP0200X | Pediatric Occupational Therapist | — | GA | — |

## Other

- **Enumeration date:** 05/16/2008
- **Last updated:** 05/16/2008