Individual
COREY KEVIN COLBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
610 E BELLA VISTA ST, LAKELAND, FL 33805-3008
(863) 688-8591
Mailing address
5104 ARMOR RD, PLANT CITY, FL 33567-2662
(904) 233-0611
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
17667
FL
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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