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Organization

HEAVEN'S GAIT THERAPEUTIC RIDING, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY RICKARD (OWNER/DIRECTOR)
(770) 656-5764
Entity
Organization

Contact information

Practice address
2471 E CHEROKEE DR, WOODSTOCK, GA 30188-2000
(770) 656-5764
Mailing address
2471 E CHEROKEE DR, WOODSTOCK, GA 30188-2000

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
80218
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
80218
PATH INTERNATIONAL CERTIFICATION
Enumeration date
09/08/2016
Last updated
09/08/2016
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