Organization
PEACH STATE PEDIATRIC THERAPY
Active
Organization
PEACH STATE PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGARET ANN KUNEYL OTRL (CEO)
(770) 904-6419
Entity
Organization
Contact information
Practice address
4992 BRISTOL INDUSTRIAL WAY, BUFORD, GA 30518-1742
(770) 904-6419
(770) 904-6418
Mailing address
4992 BRISTOL INDUSTRIAL WAY, BUFORD, GA 30518-1742
(770) 904-6419
(770) 904-6418
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT004775
GA
Other
Enumeration date
02/05/2016
Last updated
02/05/2016
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