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Individual

JOSHUA ADAM BROTHEIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
940 S ENOTA DR NE, GAINESVILLE, GA 30501-2451
(919) 424-5080
Mailing address
6802 WOLF RUN LN, NORTH FORT MYERS, FL 33917-3364
(239) 218-7296

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002654
GA
224Z00000X
Occupational Therapy Assistant
OTA13276
FL

Other

Enumeration date
04/13/2020
Last updated
04/13/2020
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