Organization
KIDS THAT CAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT NYE (BUSINESS MANAGER)
(678) 632-6765
Entity
Organization
Contact information
Practice address
1130 SENOIA ROAD, SUITE A1, TYRONE, GA 30290-1640
(678) 632-6765
(678) 550-7931
Mailing address
1130 SENOIA ROAD, SUITE A1, TYRONE, GA 30290-1640
(678) 632-6765
(678) 550-7931
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
05/02/2013
Last updated
11/02/2016
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