Individual
JACOB GARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2S814 WAGNER RD, BATAVIA, IL 60510-9368
(630) 639-7879
Mailing address
2S814 WAGNER RD, BATAVIA, IL 60510-9368
(630) 639-7879
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.010713
IL
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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