Individual
MRS. JESI LEANN BACKLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4343 OAK GROVE BLVD., SAN ANGELO, TX 76904-4500
(325) 942-4000
Mailing address
906 N ADAMS ST, SAN ANGELO, TX 76901-1604
(325) 234-0752
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
117535
TX
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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