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Individual

MR. JASON ULYSSES TERRY SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
2131 DAVIDSONVILLE RD, CROFTON, MD 21114-1632
(410) 800-7733
Mailing address
4353 CHAPELDALE RD, RANDALLSTOWN, MD 21133-1031
(410) 800-7733

Taxonomy

Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
A01510
MD

Other

Enumeration date
08/20/2019
Last updated
08/20/2019
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