Organization
CHILDREN'S THERAPY CONCEPTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM MALLON DPT (PHYSICAL THERAPIST)
(757) 812-3288
Entity
Organization
Contact information
Practice address
24030 INDIAN TOWN RD, COURTLAND, VA 23837-2371
(757) 812-3288
Mailing address
24030 INDIAN TOWN RD, COURTLAND, VA 23837-2371
(757) 812-3288
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
2305204928
VA
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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