Individual
JERRY LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1610 CENTENARY DR, RICHARDSON, TX 75081-3806
(469) 226-1812
(469) 226-1812
Mailing address
1610 CENTENARY DR, RICHARDSON, TX 75081-3806
(469) 226-1812
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214705
TX
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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