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Individual

MR. KEVIN SCOTT WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
310 E WARDELL DR, PEMBROKE, NC 28372-7997
(910) 521-1273
(910) 521-3593
Mailing address
28945 HOFFMAN RD, MARSTON, NC 28363-8131
(910) 277-9103

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0832
NC

Other

Enumeration date
11/22/2012
Last updated
11/22/2012
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