Individual
LARRY PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1122 N ESHMAN AVE, WEST POINT, MS 39773-5436
(662) 494-6011
Mailing address
PO BOX 817, WEST POINT, MS 39773-0817
(662) 494-3011
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA2416
MS
Other
Enumeration date
02/14/2014
Last updated
02/14/2014
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