Individual
JUSTIN LEVI MCMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
20 VILLAGE CIR, KEOKUK, IA 52632-2040
(319) 524-5772
Mailing address
415 20TH ST, FORT MADISON, IA 52627-2403
(319) 795-0389
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
501330
IA
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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