Organization
READY SET GROW PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHALI NICOLE DENISON OTR/L (CLINICAL DIRECTOR/OT)
(423) 736-7369
Entity
Organization
Contact information
Practice address
1241 VOLUNTEER PKWY STE 400, BRISTOL, TN 37620-4635
(910) 818-0977
Mailing address
13 PENDLETON PL, KINGSPORT, TN 37664-2169
(423) 736-7369
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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