Individual
MICAH LOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
135 HOYT ST, ATHENS, GA 30601-2646
(706) 549-0031
(706) 549-0032
Mailing address
135 HOYT ST, ATHENS, GA 30601-2646
(706) 549-0031
(706) 549-0032
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002057
GA
Other
Enumeration date
04/04/2016
Last updated
04/04/2016
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