ELY ANTHONY GREEN

JACKSON, MS
NPI1174716260
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: MS  TA1448)
Enumeration Date2007-08-22
Last Update Date2007-08-22
Business Address
-- ELY ANTHONY GREEN OTA/L
13 NORTHTOWN DR SUITE 110
JACKSON, MS 39211-3047
Phone number: 601-206-9195
Mailing Address
-- ELY ANTHONY GREEN OTA/L
13 NORTHTOWN DR SUITE 110
JACKSON, MS 39211-3047
Phone number: 601-206-9195
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