Individual
JOSHUA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 W PARK AVE, VALDOSTA, GA 31602-2507
(229) 253-8500
Mailing address
202 W PARK AVE, VALDOSTA, GA 31602-2507
(229) 253-8500
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001858
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA001858
GEORGIA SECRETARY OF STATE
GA
Enumeration date
03/24/2015
Last updated
03/24/2015
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