Organization
ADAPTIVE PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRIA BAILEY BURCH (OWNER)
(850) 557-4603
Entity
Organization
Contact information
Practice address
4540 LAFAYETTE ST STE C, MARIANNA, FL 32446-3236
(850) 557-4603
Mailing address
4540 LAFAYETTE ST STE C, MARIANNA, FL 32446-3236
(850) 557-4603
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/12/2023
Last updated
07/10/2023
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