Organization
VAN VARICK PEDIATRIC PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH SAINT JOHN DPT (CFO)
(561) 707-5209
Entity
Organization
Contact information
Practice address
1000 HOLCOMB WOODS PKWY, SUITE 422, ROSWELL, GA 30076-2575
(770) 641-8070
Mailing address
1000 HOLCOMB WOODS PKWY, SUITE 422, ROSWELL, GA 30076-2575
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT012056
GA
2251P0200X
Pediatric Physical Therapist
Primary
PT012056
GA
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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