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Organization

SOUTHERN PIEDMONT PEDIATRIC THERAPY, LLC

Active
Other names
Southern Piedmont Pediatric Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
GARRET TOMMASULO (MEMBER/MANAGER)
(704) 604-2585
Entity
Organization

Contact information

Practice address
1028 ANTIOCH WOODS LN, MATTHEWS, NC 28104-7406
(704) 604-2585
Mailing address
1028 ANTIOCH WOODS LN, MATTHEWS, NC 28104-7406

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
01/17/2025
Last updated
01/17/2025
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