BRANTLEY WARREN DAVIS

SUMRALL, MS
NPI1003191461
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: TX  211203)
Enumeration Date2011-10-18
Last Update Date2011-10-18
Business Address
-- BRANTLEY WARREN DAVIS COTA
19 N MILL ST
SUMRALL, MS 39482-4035
Phone number: 601-466-9638
Mailing Address
-- BRANTLEY WARREN DAVIS COTA
19 N MILL ST
SUMRALL, MS 39482-4035
Phone number: