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Organization
PT FOUR KIDS LLC
Active
Organization
PT FOUR KIDS LLC
Active
Other names
PT4KIDS
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN H MAYNE PT (OWNER)
(404) 509-9761
Entity
Organization
Contact information
Practice address
4458 WINDSOR OAKS CIR, MARIETTA, GA 30066-2320
(404) 509-9761
(678) 981-6336
Mailing address
4458 WINDSOR OAKS CIR, MARIETTA, GA 30066-2320
(404) 509-9761
(678) 981-6336
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
PT002955
GA
Other
Enumeration date
05/16/2014
Last updated
05/16/2014
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