Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 46TR00027900 | NJ |
NPI | 1770617870 |
---|---|
Provider Name | Mr. Douglas William Downs |
First Address | Long Valley, NJ 07853-3158 |
Second Address | Chester, NJ 07930-2141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |