| Organization Name: | POLK SCHOOL DISTRICT |
| NPI Number: | 1427117761 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN L VASSAR (BILLING ADMINISTRATOR) |
| Mailing Address: | 612 S College St Cedartown |
| State: | GA US |
| Postal Code: | 301253522 |
| Phone Number: | 7706848718 |
| Fax Number: | 7706843221 |
| NPI Enumeration Date: | 12/06/2006 |
| NPI Last Update Date: | 10/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 06/03/2008 |
| NPI Reactivation Date: | 09/16/2008 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 235Z00000N |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |