Organization
RINCON ROOTS PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADISSON JESSE M.S. CCC-SLP (ACTING MANAGER/OWNER)
(620) 490-0098
Entity
Organization
Contact information
Practice address
409 S LAUREL ST, SPRINGFIELD, GA 31329-9261
(620) 490-0098
Mailing address
2238 E GWINNETT ST, SAVANNAH, GA 31404-2530
(620) 490-0098
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/01/2026
Last updated
07/01/2026
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