Organization
HOMEGROWN PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY HAWN (CO-OWNER)
(423) 215-6520
Entity
Organization
Contact information
Practice address
116 CUMBERLAND ST., WARTBURG, TN 37887-3788
(423) 215-6520
Mailing address
242 CUMBERLAND MOUNTAIN LN, SUNBRIGHT, TN 37872-2810
(423) 215-6520
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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