Organization
CAN DO KIDS PEDIATRIC THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNATHAN PAUL CISCO OWNER (OWNER)
(423) 476-7212
Entity
Organization
Contact information
Practice address
65 MOUSE CREEK RD NW, CLEVELAND, TN 37312-4840
(423) 476-7212
(423) 476-1673
Mailing address
65 MOUSE CREEK RD NW, CLEVELAND, TN 37312-4840
(423) 476-7212
(423) 476-1673
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/13/2015
Last updated
07/08/2022
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