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Organization

MILESTONES PEDIATRIC THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JORDAN KAY CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST, OWNER)
(229) 220-1890
Entity
Organization

Contact information

Practice address
519 S SIMS ST, BAINBRIDGE, GA 39819-4159
(229) 220-1890
(706) 223-6778
Mailing address
519 S SIMS ST, BAINBRIDGE, GA 39819-4159
(229) 220-1890
(706) 223-6778

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003211062A
GA
Enumeration date
10/20/2018
Last updated
10/20/2018
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