# PT FOUR KIDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PT4KIDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477964013
- **Authorized official:** SUSAN H MAYNE PT (OWNER)
- **Authorized official phone:** (404) 509-9761

## Contact information

- **Practice address:** 4458 WINDSOR OAKS CIR, MARIETTA, GA 30066-2320
- **Practice address phone:** (404) 509-9761
- **Practice address fax:** (678) 981-6336
- **Mailing address:** 4458 WINDSOR OAKS CIR, MARIETTA, GA 30066-2320
- **Mailing address phone:** (404) 509-9761
- **Mailing address fax:** (678) 981-6336

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | PT002955 | GA | Yes |

## Other

- **Enumeration date:** 05/16/2014
- **Last updated:** 05/16/2014