Provider Demographics
NPI:1063145514
Name:PENTATONIC THERAPIES, LLC
Entity type:Organization
Organization Name:PENTATONIC THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MMT, MT-BC
Authorized Official - Phone:478-719-0924
Mailing Address - Street 1:4261 HOLLY HILL DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31216-6123
Mailing Address - Country:US
Mailing Address - Phone:478-719-0924
Mailing Address - Fax:
Practice Address - Street 1:4261 HOLLY HILL DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31216-6123
Practice Address - Country:US
Practice Address - Phone:478-719-0924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation