Organization
PEDIATRIC THERAPY OF ORMOND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERI ESSIG (OWNER)
(386) 871-0428
Entity
Organization
Contact information
Practice address
16 BLACK WATER WAY, ORMOND BEACH, FL 32174-5706
(386) 871-0428
(386) 463-8565
Mailing address
16 BLACK WATER WAY, ORMOND BEACH, FL 32174-5706
(138) 687-1042
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016451300
—
FL
Enumeration date
02/09/2022
Last updated
02/09/2022
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