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Individual

CLAY MICHAEL MUSSELMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
164 NURSING HOME CIR, BLAIRSVILLE, GA 30512-3117
(706) 745-4948
Mailing address
147 MONTVIEW DR, JASPER, GA 30143-2176
(740) 586-1566

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002829

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
OTA002829
GA
Enumeration date
11/09/2021
Last updated
11/09/2021
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