Individual
EDWARD THOMAS ROE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
110 WOODFIELD DR, MACON, GA 31210-5625
(478) 475-7988
(478) 475-7974
Mailing address
110 WOODFIELD DR, MACON, GA 31210
(478) 475-7988
(478) 475-7974
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005565
GA
Other
Enumeration date
11/09/2012
Last updated
11/09/2012
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