Provider Demographics
NPI:1427347079
Name:NORTH GA. PEDIATRIC THERAPIES DBA CAN DO KIDS PEDIATRIC THERAPY
Entity type:Organization
Organization Name:NORTH GA. PEDIATRIC THERAPIES DBA CAN DO KIDS PEDIATRIC THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:DION 'DEE'
Authorized Official - Last Name:COGDILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-476-7212
Mailing Address - Street 1:3775 GEORGETOWN RD NW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-2567
Mailing Address - Country:US
Mailing Address - Phone:423-476-7212
Mailing Address - Fax:423-476-1673
Practice Address - Street 1:3775 GEORGETOWN RD NW
Practice Address - Street 2:SUITE 1
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-2567
Practice Address - Country:US
Practice Address - Phone:423-476-7212
Practice Address - Fax:423-476-1673
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH GA. PEDIATRIC THERAPIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN225100000X, 225X00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty