Organization
MILESTONE PEDIATRIC THERAPY SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH CHAMBERS MSOTR/L (PRESIDENT)
(678) 863-2074
Entity
Organization
Contact information
Practice address
526 JEFFERSON WALK CIR, JEFFERSON, GA 30549-5573
(678) 863-2074
(706) 367-2431
Mailing address
526 JEFFERSON WALK CIR, JEFFERSON, GA 30549-5573
(678) 863-2074
(706) 367-2431
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
OT004043
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372085900H
—
GA
Enumeration date
07/24/2013
Last updated
07/24/2013
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