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Individual
MR. OTIS EDWARD JOSLYN III
Active
Individual
MR. OTIS EDWARD JOSLYN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007636
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
416014
BCBS
GA
01
—
P00226785
RR MEDICARE
GA
05
—
TH1550
—
SC
Enumeration date
07/15/2005
Last updated
10/08/2007
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