Individual
TRAVES JEFFERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
122 DEVLIN SPRINGS DR, MADISON, MS 39110-6549
(601) 613-3437
Mailing address
122 DEVLIN SPRINGS DR, MADISON, MS 39110-6549
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA2831
MS
Other
Enumeration date
02/26/2014
Last updated
02/26/2014
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