Individual
MR. NIKOLAS DOYLE CARNATHAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
499 GLOSTER CREEK VLG, SUITE I-3, TUPELO, MS 38801-4600
(662) 844-4471
(662) 844-4472
Mailing address
499 GLOSTER CREEK VLG, SUITE I-3, TUPELO, MS 38801-4600
(662) 844-4471
(662) 844-4472
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1521
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03784371
—
MS
Enumeration date
10/31/2005
Last updated
07/09/2007
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