Individual
MR. JIMMY DALE COLLEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
9179 FRANCES RD, OTISVILLE, MI 48463-9411
(810) 210-2077
Mailing address
9179 FRANCES RD, OTISVILLE, MI 48463-9411
(810) 210-2077
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201005312
MI
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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