Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 31004385 | IN |
NPI | 1063604700 |
---|---|
Provider Name | Jeremy Ryan Vories |
First Address | Richmond, IN 47374-1908 |
Second Address | Richmond, IN 47374-1908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2007 |
Last Update Date | 16/08/2007 |