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Organization

PEDIATRIC THERAPY GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARY A KESTER OT/L (STAFF OT)
(941) 447-4707
Entity
Organization

Contact information

Practice address
4440B 26TH ST W, BRADENTON, FL 34207-1201
(941) 752-0408
Mailing address
4440B 26TH ST W, BRADENTON, FL 34207-1201
(941) 752-0408

Taxonomy

Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
T13711
FL

Other

Enumeration date
06/22/2011
Last updated
06/22/2011
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