Individual
CALVIN BRENT STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
7588 MICHAEL LN, NEWBURGH, IN 47630-8002
(765) 491-4781
Mailing address
7588 MICHAEL LN, NEWBURGH, IN 47630-8002
(765) 491-4781
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001872A
IN
Other
Enumeration date
12/29/2011
Last updated
12/29/2011
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