Organization
NEST PEDIATRIC THERAPY
Active
Organization
NEST PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE SIDES (OFFICE MANAGER)
(256) 601-1990
Entity
Organization
Contact information
Practice address
385 GOOCH LN, MADISON, AL 35758-8366
(318) 450-7268
Mailing address
385 GOOCH LN, MADISON, AL 35758-8366
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6979358
DRIVER'S LICENSE
AL
Enumeration date
03/01/2022
Last updated
03/01/2022
Update your record
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