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1174720445
JIMMY DALE BRANNON
FORDSVILLE, KY
NPI
1174720445
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: KY A3397)
Enumeration Date
2007-06-29
Last Update Date
2007-07-08
Business Address
Mr. JIMMY DALE BRANNON COTA,L
313 MAIN
FORDSVILLE, KY 42343
Phone number: 270-276-5435
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Mailing Address
Mr. JIMMY DALE BRANNON COTA,L
813 BROAD ST
CENTRAL, KY 42330
Phone number: 270-754-5280
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