Provider First Line Business Practice Location Address: 
KIDABILITIES PEDIATRIC THERAPY CENTER
    Provider Second Line Business Practice Location Address: 
2801 HIGHWAY 25E, SUITE 98
    Provider Business Practice Location Address City Name: 
MIDDLESBORO
    Provider Business Practice Location Address State Name: 
KY
    Provider Business Practice Location Address Postal Code: 
40965
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
606-302-4388
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
03/13/2018