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Organization
INTENSIVE THERAPY CENTER OF GEORGIA, INC.
Active
Organization
INTENSIVE THERAPY CENTER OF GEORGIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIE LOCICERO PT (PRESIDENT)
(678) 377-2833
Entity
Organization
Contact information
Practice address
545 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30046-3389
(678) 377-2833
(678) 377-2882
Mailing address
545 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30046-3389
(678) 377-2833
(678) 377-2882
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
NULL
2251P0200X
Pediatric Physical Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
NULL
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
01/13/2010
Last updated
01/13/2010
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