PATEN LANE WILLIS

CANTON, GA
NPI1831475318
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225XP0200X Occupational Therapist, Pediatrics
(Licence: GA  OT005366)
Enumeration Date2011-10-27
Last Update Date2011-10-27
Business Address
-- PATEN LANE WILLIS OTR/L
310 PAPER TRAIL WAY STE 302
CANTON, GA 30115-5203
Phone number: 770-345-2804
Mailing Address
-- PATEN LANE WILLIS OTR/L
310 PAPER TRAIL WAY STE 302
CANTON, GA 30115-5203
Phone number: 770-345-2804