Individual
MICHAEL WHEELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 956-3175
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12066
FL
224Z00000X
Occupational Therapy Assistant
200526
MN
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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