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Individual

MR. KEVIN JEROME HARVEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MOT

Contact information

Practice address
9540 FERNANDINA DR, DOUGLASVILLE, GA 30135-2069
(404) 290-8825
(678) 715-6221
Mailing address
9540 FERNANDINA DR, DOUGLASVILLE, GA 30135-2069
(404) 290-8825
(678) 715-6221

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004319
GA

Other

Enumeration date
01/27/2011
Last updated
01/27/2011
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