Individual
JORDAN VANWINKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3410 MAGNOLIA ST, TEXARKANA, TX 75503-3729
(903) 792-3003
(903) 794-1005
Mailing address
3410 MAGNOLIA ST, TEXARKANA, TX 75503-3729
(903) 792-3003
(903) 794-1005
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213018
TX
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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