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1790911832
WAYNE RICHARD DEFOREST
DALTON, GA
NPI
1790911832
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: GA OT002653)
Enumeration Date
2009-06-03
Last Update Date
2009-06-03
Business Address
-- WAYNE RICHARD DEFOREST OT
1013 RIVERBURCH PKWY SUITE 4
DALTON, GA 30721-8887
Phone number: 866-261-8090
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Mailing Address
-- WAYNE RICHARD DEFOREST OT
1013 RIVERBURCH PKWY SUITE 4
DALTON, GA 30721-8887
Phone number: 866-261-8090
Copy
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