Organization
NIMBLE KIDS LLC
Active
Other names
Comprehensive Therapy Children's Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN JAMES ROSS JR. (OWNER)
(770) 345-7796
Entity
Organization
Contact information
Practice address
200 RIVERSTONE DR, SUITE B, CANTON, GA 30114-5256
(770) 345-7796
(770) 479-3471
Mailing address
200 RIVERSTONE DR, SUITE B, CANTON, GA 30114-5256
(770) 345-7796
(770) 479-3471
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
GA
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050405667A
—
GA
Enumeration date
09/17/2009
Last updated
09/28/2012
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