Organization
WONDER THERAPEUTIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA B FEDDERN OTR/L (CEO)
(678) 960-3063
Entity
Organization
Contact information
Practice address
4875 HOG MOUNTAIN RD STE B, FLOWERY BRANCH, GA 30542-6450
(404) 406-8272
(770) 965-1008
Mailing address
4721 CRESTVIEW WAY, FLOWERY BRANCH, GA 30542-3501
(404) 406-8272
(404) 738-1638
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
10/12/2022
Last updated
07/26/2023
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