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1578857363
SHANNON LANE BROWN
BAY SPRINGS, MS
NPI
1578857363
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: MS TA2354)
Enumeration Date
2011-06-09
Last Update Date
2011-06-09
Business Address
Mr. SHANNON LANE BROWN COTA
43 COUNTY ROAD 1721
BAY SPRINGS, MS 39422-9804
Phone number: 601-467-3476
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Mailing Address
Mr. SHANNON LANE BROWN COTA
43 COUNTY ROAD 1721
BAY SPRINGS, MS 39422-9804
Phone number: 601-467-3476
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