Individual
MR. JEREMY BRAD KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1504 N 1ST ST, HASKELL, TX 79521-5438
(940) 864-2932
Mailing address
190 SUGAR BISCUIT LN, ABILENE, TX 79602-5546
(325) 698-5045
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208771
TX
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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