Individual
JIMMY ERIC KNOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRIL, CDRS
Contact information
Practice address
326 HORDY RD, MISSISSIPPI STATE, MI 39762
(662) 325-1028
(662) 325-0896
Mailing address
P.O. BOX 9736, MISSISSIPPI STATE, MS 39762
(662) 325-1028
(662) 325-0896
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2774
MS
225XE0001X
Environmental Modification Occupational Therapist
OT2774
MS
225XP0200X
Pediatric Occupational Therapist
OT2774
MS
225XR0403X
Driving and Community Mobility Occupational Therapist
OT2774
MS
Other
Enumeration date
03/22/2018
Last updated
03/22/2018
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