Organization
CAPITAL CITY THERAPY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINE SPEEGLE OT (OWNER)
803804791758
Entity
Organization
Contact information
Practice address
100 OLD CHEROKEE RD, SUITE F, BOX 172, LEXINGTON, SC 29072-9316
(803) 467-8596
(803) 356-0468
Mailing address
100 OLD CHEROKEE RD, SUITE F, BOX 172, LEXINGTON, SC 29072-9316
(803) 467-8596
(803) 356-0468
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2606
SC
235Z00000X
Speech-Language Pathologist
3537
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0661
—
SC
05
—
TH1349
—
SC
Enumeration date
03/29/2011
Last updated
03/29/2011
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