Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT3533 | MS |
NPI | 1215591169 |
---|---|
Provider Name | Ferris O'bannon Mcguire |
First Address | Batesville, MS 38606-3017 |
Second Address | Batesville, MS 38606-3017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2019 |
Last Update Date | 25/04/2019 |