Individual
MR. CHARLES PAUL RICKETSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
807 S PARSONS AVE, BRANDON, FL 33511-6063
(813) 684-8141
(813) 689-1140
Mailing address
807 S PARSONS AVE, BRANDON, FL 33511-6063
(813) 684-8141
(813) 689-1140
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 9814
FL
Other
Enumeration date
11/07/2006
Last updated
04/15/2008
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