Organization
MAGICAL MILESTONES PEDIATRIC REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BIRD (OWNER)
(704) 622-0355
Entity
Organization
Contact information
Practice address
1003 TOQUIMA TRL, MONROE, NC 28110-6339
(704) 622-0355
Mailing address
1003 TOQUIMA TRL, MONROE, NC 28110-6339
(704) 622-0355
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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