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1053613802
JUSTIN ORAN MCDIVITT
COOKEVILLE, TN
NPI
1053613802
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: TN 4071)
Enumeration Date
2010-11-30
Last Update Date
2010-11-30
Business Address
DR. JUSTIN ORAN MCDIVITT OTD, R/L
815 S WALNUT AVE
COOKEVILLE, TN 38501-5956
Phone number: 931-646-7216
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Mailing Address
DR. JUSTIN ORAN MCDIVITT OTD, R/L
952 NOTTINGHAM DR
COOKEVILLE, TN 38506-4310
Phone number:
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