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Organization
PREMIER CHILDRENS THERAPY CENTER
Active
Organization
PREMIER CHILDRENS THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER F KOVANIS MS OTR/L (PRESIDENT)
(770) 641-8070
Entity
Organization
Contact information
Practice address
1000 HOLCOMB WOODS PKWY STE 422, ROSWELL, GA 30076-4718
(770) 641-8070
(770) 641-8078
Mailing address
700 AMSTER GREEN DR, ATLANTA, GA 30350-4139
(770) 641-8070
(770) 641-8078
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300035640A
—
GA
Enumeration date
08/10/2007
Last updated
07/12/2023
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