ANTHONY JAY EZELL

MEADVILLE, MS
NPI1295851970
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: MS  TA1041)
Enumeration Date2007-03-22
Last Update Date2007-07-08
Business Address
Mr. ANTHONY JAY EZELL COTAL
113 MAIN ST.
MEADVILLE, MS 39653
Phone number: 601-384-1898
Mailing Address
Mr. ANTHONY JAY EZELL COTAL
9230 BERRYTOWN RD SE
MEADVILLE, MS 39653-9035
Phone number: 601-384-1562