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Organization
PEDIATRIC MOBILITY
Active
Organization
PEDIATRIC MOBILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TED LAMAR HYDE (OWNER/MANAGER)
(478) 474-5641
Entity
Organization
Contact information
Practice address
130 COLLEGE ST, MACON, GA 31201-1607
(478) 951-7576
Mailing address
1058 WARWICK DR, MACON, GA 31210-1540
(478) 474-5641
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
03/17/2008
Last updated
03/17/2008
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