Individual
MR. JOSEPH EDWARD SHAW III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
655 MOLLY LN STE 4, WOODSTOCK, GA 30189-6503
(770) 517-1080
Mailing address
655 MOLLY LN STE 4, WOODSTOCK, GA 30189-6503
(770) 517-1080
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT006977
GA
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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