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1831475318
PATEN LANE WILLIS
CANTON, GA
NPI
1831475318
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225XP0200X Occupational Therapist, Pediatrics
(Licence: GA OT005366)
Enumeration Date
2011-10-27
Last Update Date
2011-10-27
Business Address
-- PATEN LANE WILLIS OTR/L
310 PAPER TRAIL WAY STE 302
CANTON, GA 30115-5203
Phone number: 770-345-2804
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Mailing Address
-- PATEN LANE WILLIS OTR/L
310 PAPER TRAIL WAY STE 302
CANTON, GA 30115-5203
Phone number: 770-345-2804
Copy
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