Individual
PHILLIP ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
569 MARDELL LN, HOWE, TX 75459-4452
(903) 532-3945
Mailing address
569 MARDELL LN, HOWE, TX 75459-4452
(903) 532-3945
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
206750
TX
Other
Enumeration date
11/18/2010
Last updated
11/18/2010
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