Individual
JEREMIAH ALLEN BODI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
148 WILSON ST, DEFIANCE, OH 43512-1440
(419) 956-1612
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 04970
OH
Other
Enumeration date
08/13/2012
Last updated
08/13/2012
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