Organization
COMPLEAT KIDZ PEDIATRIC THERAPY, LLC
Active
Parent organization
COMPLEAT KIDZ PEDIATRIC THERAPY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMPLEAT KIDZ PEDIATRIC THERAPY, LLC
Authorized official
MR. DERRICK FICKLING (SENIOR PAYER RELATIONS MANAGER)
(888) 580-6180
Entity
Organization
Contact information
Practice address
54 MYRTLE ST, BELMONT, NC 28012-5200
(704) 915-6193
Mailing address
54 MYRTLE ST, BELMONT, NC 28012-5200
(704) 915-6193
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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