Organization
THROUGH THE ROOF PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA B SULARIN P.T, (EXECUTIVE DIRECTOR, P.T.)
(901) 568-2240
Entity
Organization
Contact information
Practice address
1145 MILAM LN, HERNANDO, MS 38632-7719
(901) 568-2240
Mailing address
1895 THOUSAND OAKS DR, HERNANDO, MS 38632-8914
(901) 568-2240
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT0828
MS
225XP0200X
Pediatric Occupational Therapist
OT2977
MS
235Z00000X
Speech-Language Pathologist
S3688
MS
Other
Enumeration date
08/06/2015
Last updated
08/06/2015
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