Organization
PEDIATRIC PT LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANJA ELLIOTT (OFFICE MANAGER)
(256) 235-2524
Entity
Organization
Contact information
Practice address
1705 LEIGHTON AVE, ANNISTON, AL 36207-3832
(256) 235-2524
(256) 236-2573
Mailing address
1106 HERITAGE LN NE, JACKSONVILLE, AL 36265-1255
(256) 235-2524
(256) 236-2573
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890001880
—
AL
Enumeration date
11/21/2016
Last updated
02/08/2017
About Stedi
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