Children'S Therapy Concepts LLC
Organization Active NPI Early Intervention Provider Agency · Courtland, VA
NPI 1043769615 · NPPES record last updated Sep 23, 2016
Key facts
- NPI
- 1043769615
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Early Intervention Provider Agency 252Y00000X
- License
- 2305204928 (VA)
- Legal business name
- CHILDREN'S THERAPY CONCEPTS LLC
- Practice address
- 24030 Indian Town Rd
Courtland, VA 23837-2371 - Phone
- (757) 812-3288
- NPI assigned
- Sep 23, 2016
- Organization subpart
- No
Authorized official
- Name
- Kim Mallon, DPT
- Title
- Physical Therapist
- Phone
- (757) 812-3288
Practitioners 2
-
Stevie Jo Nicole Tibbetts, MOT, OTR/L
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | 2305204928 | VA | Yes |
Addresses
Primary practice location
24030 Indian Town Rd
Courtland, VA 23837-2371
Mailing address
24030 Indian Town Rd
Courtland, VA 23837-2371
Phone (757) 812-3288
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- Commonwealth of Virginia State Board of Health
- Courtland Hearing AIDS and Balance, LLC
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- Joshua Alexander Diggins
All providers in Courtland, VA · Early Intervention Provider Agency in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.