Mr. Joseph Albert Church III
Occupational Therapist - Hand
1105 39th Ave
Gulfport
, Mississippi 39501-2654
Mr. Joseph Albert Church III
Occupational Therapist - Hand
1105 39th Ave
Gulfport
, Mississippi 39501-2654
(228) 575-4651
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About
Features
Specialties
- Occupational Therapist - Hand
Languages spoken
- English
Location
First Address
- Mr. Joseph Albert Church III
- 1105 39th Ave
- Gulfport, MS
- Zip : 39501-2654
- Fax : (228) 575-4651
- Phone : (228) 575-4654
Second Address
- Mr. Joseph Albert Church III
- 1105 39th Ave
- Gulfport, MS
- Zip : 39501-2654
- Fax : (228) 575-4651
- Phone : (228) 575-4654
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XH1200X | Occupational Therapist - Hand | OT0116 | MS |
National Provider Identifier
| NPI | 1265470744 |
|---|---|
| Provider Name | Mr. Joseph Albert Church III |
| First Address | Gulfport, MS 39501-2654 |
| Second Address | Gulfport, MS 39501-2654 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/06/2006 |
| Last Update Date | 29/01/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00119593 | (05) | MS |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.