Organization
ACTIVEKIDZ AND ADULT THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN GERALD COOK (OWNER)
(770) 207-6390
Entity
Organization
Contact information
Practice address
212 W 3RD ST SW, ROME, GA 30165-2802
(706) 295-4260
Mailing address
1431 CAPITAL AVE STE 123, WATKINSVILLE, GA 30677-1883
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
—
—
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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