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Individual

MR. DAVID JUSTICE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
450 CC ANDREWS RD, TIMBERLAKE, NC 27583-8935
(505) 803-1643
Mailing address
450 CC ANDREWS RD, TIMBERLAKE, NC 27583-8935
(505) 803-1643

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9900
NC

Other

Enumeration date
01/10/2017
Last updated
01/10/2017
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