Terry Lee Goheen II COTA/L

NPI 1093094013 - Occupational Therapy Assistant - 224Z00000X

NPI Details
NPI 1093094013
Gender Male
Enumeration Date 08/08/2011
Last Updated 08/08/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
15874 MEDORA ST
DOW IL, 62022-3173, US
Phone (618) 885-5602
Fax
Business Location
15874 MEDORA ST
DOW IL, 62022-3173, US
Phone (618) 885-5602
Fax
Toxanomy
Taxonomy Code 224Z00000X
License State Illinois
License Number 057.003047
Remove 1093094013 NPI Number
 

According to our database, Mr. Terry Lee Goheen II COTA/L NPI is 1093094013, taxonomy code is 224Z00000X and license number is 057.003047, license state is located at Illinois. Terry Lee Goheen II COTA/L physically located at 15874 Medora St, Dow IL, 62022-3173. NPI Number Terry Lee Goheen II COTA/L has the Individual type.

Sponsored links

1093094013 NPI number is provided on an as is basis without warranty of any kind. 1093094013 is maintained by the National Plan & Provider Enumeration System. The contents of Terry Lee Goheen II COTA/L are for informational purposes only.