Organization
LIVE TO THE MAX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE ROSE LILES MHS, OTR/L (OWNER)
(229) 894-1353
Entity
Organization
Contact information
Practice address
206 BRIDGEWATER TRL, CANTON, GA 30115-4566
(229) 894-1353
Mailing address
206 BRIDGEWATER TRL, CANTON, GA 30115-4566
(229) 894-1353
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
09/13/2023
Last updated
10/07/2023
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