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Organization

PEDIATRIC THERAPY OF ORMOND, LLC

Active
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Organization

PEDIATRIC THERAPY OF ORMOND, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERI ESSIG MPT (OWNER/PHYSICAL THERAPIST)
(386) 871-0428
Entity
Organization

Contact information

Practice address
16 BLACK WATER WAY, ORMOND BEACH, FL 32174-5706
(386) 871-0428
Mailing address
16 BLACK WATER WAY, ORMOND BEACH, FL 32174-5706

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 23030
FL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
SA 1622
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892586100
—
FL
Enumeration date
12/19/2007
Last updated
02/09/2022
About Stedi
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