Organization
PEDIATRIC DEVELOPMENT CENTER OF ATLANTA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J. WING (VICE PRESIDENT)
(207) 831-8871
Entity
Organization
Contact information
Practice address
2694 HUGHES ST SE, SMYRNA, GA 30080-1920
(770) 405-8542
Mailing address
2694 HUGHES ST SE, SMYRNA, GA 30080-1920
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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