John Broome II, COTA/L
Occupational Therapy Assistant in Trinity, NC. Individual provider (NPI-1).
NPI number1568802437
StatusActive
Last updated in NPPESJun 25, 2013
Details
- NPI
- 1568802437
- Entity type
- Individual (NPI-1)
- Name
- John Broome II
- Credential
- COTA/L
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 25, 2013
- Last updated
- Jun 25, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | 8726 | NC | Yes |
Practice location
116 Lane DrTrinity, NC 27370-9343
Phone 336-431-8888
Mailing address
136 Mackwood RdMooresville, NC 28115-7819
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