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Organization

DUCKTAILS PEDIATRIC THERAPY AND WELLNESS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY ROSS (OWNER / OTRL)
(706) 364-5262
Entity
Organization

Contact information

Practice address
568 BLUE RIDGE DR, EVANS, GA 30809-3604
(706) 364-5262
(706) 364-5263
Mailing address
568 BLUE RIDGE DR, EVANS, GA 30809-3604
(706) 364-5262
(706) 364-5263

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
003593
GA
261QP2000X
Physical Therapy Clinic/Center
PT004118
GA
261QP2000X
Physical Therapy Clinic/Center
PT004423
GA
261QP2000X
Physical Therapy Clinic/Center
PT008564
GA
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000717274C
GA
05
000767456C
GA
Enumeration date
08/22/2006
Last updated
06/18/2025
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