Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT006704 | GA |
NPI | 1346751716 |
---|---|
Provider Name | Mr. Michael Amory |
First Address | Atlanta, GA 30324-3849 |
Second Address | Atlanta, GA 30324-3849 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2017 |
Last Update Date | 12/10/2017 |