| Appalachian Pediatric Therapy, Llc | |
|
5400 Fort Henry Dr Ste 12 Kingsport TN 37663-5304 | |
| (423) 426-3304 | |
| Not Available |
| Full Name | Appalachian Pediatric Therapy, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 5400 Fort Henry Dr Ste 12, Kingsport, Tennessee |
| Authorized Official Name and Position | Wendi Young Minutolo (CO-OWNER/LBA) |
| Authorized Official Contact | 4234263304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Appalachian Pediatric Therapy, Llc 118 Patrick Henry Cir Kingsport TN 37663-3733 Ph: (423) 426-3304 | Appalachian Pediatric Therapy, Llc 5400 Fort Henry Dr Ste 12 Kingsport TN 37663-5304 Ph: (423) 426-3304 |
| NPI Number | 1104433630 |
|---|---|
| Provider Enumeration Date | 09/29/2020 |
| Last Update Date | 09/29/2020 |
| Certification Date | 09/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104433630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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