Individual
PAUL REVERE FLETCHER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
5050 LINCOLN AVE, EVANSVILLE, IN 47715-7390
(844) 553-0199
Mailing address
2116 E POWELL AVE, EVANSVILLE, IN 47714-2228
(812) 480-9291
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31006771A
IN
Other
Enumeration date
01/23/2019
Last updated
01/23/2019
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