Individual
JEFFREY CLAY WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
2564 FOXPOINTE DRIVE, COLUMBUS, IN 47203
(812) 375-8869
Mailing address
3519 HARMONY LN, CHARLESTOWN, IN 47111-8660
(812) 375-8869
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003316A
IN
Other
Enumeration date
04/24/2018
Last updated
04/24/2018
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