Organization
TRI-STATE REHABILITATION INC.
Active
Other names
Valdosta Pediatric Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK LARRY GEORGE OTR/L (OWNER)
(229) 253-8500
Entity
Organization
Contact information
Practice address
200 W MOORE ST, VALDOSTA, GA 31602-2919
(229) 253-8500
(229) 253-8522
Mailing address
200 W MOORE ST, VALDOSTA, GA 31602-2919
(229) 253-8500
(229) 253-8522
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
000668
GA
225100000X
Physical Therapist
002693
GA
225100000X
Physical Therapist
008640
GA
225X00000X
Occupational Therapist
Primary
000755
GA
225X00000X
Occupational Therapist
003018
GA
225X00000X
Occupational Therapist
003031
GA
235Z00000X
Speech-Language Pathologist
002047
GA
235Z00000X
Speech-Language Pathologist
004442
GA
235Z00000X
Speech-Language Pathologist
005367
GA
235Z00000X
Speech-Language Pathologist
006513
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300028433A
—
GA
Enumeration date
01/18/2007
Last updated
07/23/2020
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