Organization
PROGRESS VILLAGE PEDIATRIC THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIONNE BRUNSON OTR/L (OWNER)
(404) 932-3440
Entity
Organization
Contact information
Practice address
2385 LAWRENCEVILLE HWY STE A, DECATUR, GA 30033-3168
(404) 289-4270
(404) 289-4428
Mailing address
2949 STONECREST PT, CONYERS, GA 30094-4955
(404) 932-3440
(770) 483-3955
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
001419
GA
Other
Enumeration date
02/23/2012
Last updated
11/29/2024
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