Organization
KIDNETIC ENERGY,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY CHRISTINE MAGUIRE (OFFICE MANAGER)
(706) 854-8434
Entity
Organization
Contact information
Practice address
536 GRAND SLAM DR, EVANS, GA 30809-8014
(706) 854-8434
Mailing address
536 GRAND SLAM DR, EVANS, GA 30809-8014
(706) 854-8434
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007370
GA
Other
Enumeration date
01/31/2007
Last updated
08/22/2020
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