Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 6041 | NC |
NPI | 1003037599 |
---|---|
Provider Name | Mr. Shawn Styles |
First Address | West Palm Beach, FL 33413 |
Second Address | Charleston, SC 29407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |