Individual
MARY JARVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
866 MILLERS WAY, PORT ORANGE, FL 32127-5890
(386) 566-2166
Mailing address
866 MILLERS WAY, PORT ORANGE, FL 32127-5890
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12822
FL
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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