Individual
MRS. SUSAN WHITNEY POPOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
105 WALLACE DR, TULLAHOMA, TN 37388-4627
(931) 581-6789
Mailing address
105 WALLACE DR, TULLAHOMA, TN 37388-4627
(931) 581-6789
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0605
TN
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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