Individual
JOSEPH SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 PINE CONE DR, PALM COAST, FL 32164-8423
(800) 796-0923
Mailing address
25 PINE CONE DR, PALM COAST, FL 32164-8423
(800) 796-0923
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
700
AL
Other
Enumeration date
03/30/2012
Last updated
03/30/2012
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