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Contact Information

ACTIVEKIDZ AND ADULT THERAPY SERVICES
348 BIG A RD
TOCCOA, GA30577
 Phone: 770-207-6390
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for ACTIVEKIDZ AND ADULT THERAPY SERVICES

NPI Number 1073983953
LBN Legal business name ACTIVEKIDZ AND ADULT THERAPY SERVICES
Authorized official SUSAN COOK - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/05/2015
Last updated 07/27/2016 - About 3 years ago
Identifiers
GA License # 5588
GA Medicaid 000875102B
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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