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Individual

MR. TERRY CRAVENS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
3088 LENOX RD NE, ATLANTA, GA 30324-2894
(404) 846-8335
Mailing address
1415 RED TAIL CT, MABLETON, GA 30126-1269
(321) 914-9129

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002007
GA

Other

Enumeration date
04/28/2016
Last updated
04/28/2016
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