Individual
JODY TACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
211 MAIN ST, OWEGO, NY 13827-1633
(607) 948-4047
Mailing address
261 BARNES HILL RD, LOCKWOOD, NY 14859-9615
(607) 425-5344
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
NY
Other
Enumeration date
03/30/2017
Last updated
03/30/2017
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