Individual
MR. CHARLES DAN ALLISON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, OTR/L
Contact information
Practice address
326 HARDY ROAD, MISSISSIPPPI STATE, MS 39762
(662) 325-1028
Mailing address
2395 RIVIERA RD, STARKVILLE, MS 39759-8447
(662) 325-0886
(662) 325-0896
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2147
MS
225XR0403X
Driving and Community Mobility Occupational Therapist
OT2147
MS
Other
Enumeration date
01/30/2012
Last updated
01/30/2012
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