Individual
KOUSHICK CHAKRABORTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
3209 BRISTOL HWY, JOHNSON CITY, TN 37601-1515
(423) 282-3311
Mailing address
1208 VANLEER AVE, JOHNSON CITY, TN 37604-2306
(423) 434-2200
(423) 434-2200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119004307
VA
225X00000X
Occupational Therapist
108485
TX
225X00000X
Occupational Therapist
OT 5031
CA
225X00000X
Occupational Therapist
Primary
OT0000003621
TN
225X00000X
Occupational Therapist
OTR1219
AR
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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