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1063122653
MARVIN LACEY
KNOXVILLE, TN
NPI
1063122653
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
224ZE0001X Occupational Therapy Assistant Environmental Modification
(Licence: 0625)
Enumeration Date
2022-12-05
Last Update Date
2022-12-05
Business Address
MARVIN LACEY COTA
10133 SHERRILL BLVD
KNOXVILLE, TN 37932-3347
Phone number: 929-342-0706
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Mailing Address
MARVIN LACEY COTA
2560 KEY ST APT 4L
TOLEDO, OH 43614-4818
Phone number: 419-917-2322
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