Organization
PEDIATRIC THERAPY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDY COVENEY (INSURANCE COORDINATOR)
(770) 355-5960
Entity
Organization
Contact information
Practice address
300 BAINBRIDGE DR NW, ATLANTA, GA 30327-4271
(770) 355-5960
Mailing address
300 BAINBRIDGE DR NW, ATLANTA, GA 30327-4271
(770) 355-5960
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0003329
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52026256
BLUE CROSS BLUE SHIELD
GA
Enumeration date
05/25/2007
Last updated
08/22/2020
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