Organization
ABC PEDIATRIC THERAPY LLC
Active
Other names
ABC Pediatric Therapy Network
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L RUCKER (CEO)
(732) 678-6119
Entity
Organization
Contact information
Practice address
7591 TYLERS PLACE BLVD, WEST CHESTER, OH 45069
(513) 755-6600
(513) 755-3762
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(914) 294-4050
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0406425
—
OH
Enumeration date
07/08/2006
Last updated
08/12/2022
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