Organization
GIG GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZETTE ROSARIO (OWNER)
(256) 225-2726
Entity
Organization
Contact information
Practice address
14 TWELVE OAKS RD, PORT WENTWORTH, GA 31407-6009
(256) 225-2726
Mailing address
14 TWELVE OAKS RD, PORT WENTWORTH, GA 31407-6009
(256) 225-2726
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-13-12833
AL
106S00000X
Behavior Technician
RBT-15-4794-10789
GA
152W00000X
Optometrist
—
GA
225100000X
Physical Therapist
Primary
—
GA
225X00000X
Occupational Therapist
—
GA
235Z00000X
Speech-Language Pathologist
—
GA
Other
Enumeration date
04/12/2016
Last updated
01/16/2017
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