Individual
CHARLES JUSTIN BRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
544 RUGBY PL, BOSSIER CITY, LA 71111-4816
(318) 455-0279
Mailing address
544 RUGBY PL, BOSSIER CITY, LA 71111-4816
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.200266
LA
Other
Enumeration date
05/17/2016
Last updated
05/17/2016
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