JERRY LEE SHIELDS

TROY, OH
NPI1952645418
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: OH  OTA04502)
Enumeration Date2012-11-21
Last Update Date2012-11-21
Business Address
-- JERRY LEE SHIELDS COTA
512 CRESCENT DR
TROY, OH 45373-2718
Phone number: 937-546-4204
Mailing Address
-- JERRY LEE SHIELDS COTA
512 CRESCENT DR
TROY, OH 45373-2718
Phone number:
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