Individual
MR. CASEY LYNN STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
109 HICKORY LN, CLINTON, MS 39056-5412
(601) 362-4471
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2927
MS
Other
Enumeration date
01/06/2017
Last updated
01/06/2017
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