Individual
TIMOTHY ALAN PURVIANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
5108 PIN OAK DR, AMARILLO, TX 79110-4625
(806) 463-7523
Mailing address
PO BOX 19914, AMARILLO, TX 79114-1914
(806) 463-7523
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209125
TX
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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