Individual
MR. JERRY FROST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
950 N LAKEVIEW DR, GREENSBURG, IN 47240-3405
(812) 662-7778
Mailing address
950 N LAKEVIEW DR, GREENSBURG, IN 47240-3405
(812) 662-7778
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000894A
IN
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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