Individual
EDMOND THOMAS COKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
104 LINKS VIEW CT, BONAIRE, GA 31005-4752
(478) 447-2390
Mailing address
104 LINKS VIEW CT, BONAIRE, GA 31005-4752
(478) 447-2390
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
362282
GA
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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