Organization
PEDIATRIC THERAPY GROUP SERVICES
Active
Organization
PEDIATRIC THERAPY GROUP SERVICES
Active
Other names
Martin Pickett
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN MARTIN PICKETT (OWNER)
18432707022
Entity
Organization
Contact information
Practice address
4440 26TH ST W, STE B, BRADENTON, FL 34207-1201
(941) 752-0408
(941) 870-0876
Mailing address
4440 26TH ST W, STE B, BRADENTON, FL 34207-1201
(941) 752-0408
(941) 870-0876
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
PT25967
FL
225XP0200X
Pediatric Occupational Therapist
OT11414
FL
225XP0200X
Pediatric Occupational Therapist
OT12006
FL
235Z00000X
Speech-Language Pathologist
SA7026
FL
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004007400
—
FL
05
—
004007401
—
FL
Enumeration date
08/15/2011
Last updated
03/22/2012
Update your record
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