Individual
MR. ROBERT JEROME UTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
300 HOSPITAL ROAD / IPMC, FT GORDON, GA 30905-5650
(706) 787-8212
Mailing address
300 HOSPITAL ROAD/IPMC, FT GORDON, GA 30905-5650
(706) 787-8212
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001471
GA
Other
Enumeration date
10/10/2013
Last updated
10/10/2013
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