Individual
JOE EMMANUEL CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
20 SHERWOOD RIDGE RD, POMONA, NY 10970-3215
(845) 825-2390
Mailing address
20 SHERWOOD RIDGE RD, POMONA, NY 10970-3215
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009307
NY
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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