Provider Demographics
NPI:1730591991
Name:KIDOLOGY, INC
Entity type:Organization
Organization Name:KIDOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BARTLEY
Authorized Official - Middle Name:V
Authorized Official - Last Name:HEATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-983-0488
Mailing Address - Street 1:1244 N FLINT STREET
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-5239
Mailing Address - Country:US
Mailing Address - Phone:855-983-0488
Mailing Address - Fax:704-240-3500
Practice Address - Street 1:1244 N FLINT STREET
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-5239
Practice Address - Country:US
Practice Address - Phone:855-983-0488
Practice Address - Fax:704-240-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP126582251P0200X
225X00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty