Individual
MANDY KORINNE RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1204 FRYE ST, ATHENS, TN 37303-3052
(423) 745-0434
Mailing address
684 PEACHTREE LN, KINGSTON, TN 37763-2112
(865) 919-7872
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2876
TN
Other
Enumeration date
08/25/2017
Last updated
08/25/2017
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