Organization
PEDIATRIC DEVELOPMENT CENTER OF ATLANTA, LLC
Active
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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