Organization
FLOYD PEDIATRIC THERAPY AND INTERVENTION FOR TIC DISORDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT FOREMAN (BILLING)
(630) 216-9437
Entity
Organization
Contact information
Practice address
651 S MOUNT JULIET RD, MOUNT JULIET, TN 37122-6319
(757) 969-2300
Mailing address
651 S MOUNT JULIET RD, MOUNT JULIET, TN 37122-6319
(757) 969-2300
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
01/16/2021
Last updated
01/16/2021
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