Individual
RYAN LEE DEXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
7410 WILLOW CREEK DR, CHARLOTTE, NC 28270-2853
(803) 493-3567
Mailing address
7410 WILLOW CREEK DR, CHARLOTTE, NC 28270-2853
(803) 493-3567
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
8730
NC
Other
Enumeration date
09/25/2014
Last updated
06/27/2016
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