Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 0119006860 | VA |
NPI | 1306465836 |
---|---|
Provider Name | William Garrett Mclees |
First Address | Richmond, VA 23227-4102 |
Second Address | Richmond, VA 23227-4102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2020 |
Last Update Date | 14/04/2020 |