Individual
MICHAEL DAVID PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
703 ROBINSON RD, JACKSON, MI 49203-2538
(517) 787-5140
Mailing address
13432 CORNELL RD, CONCORD, MI 49237-9725
(989) 808-2870
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3081088
MI
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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