Individual
JEFFERY SHAWN UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
2305 AARON ST APT 111, PORT CHARLOTTE, FL 33952-5309
(941) 255-9468
(941) 255-9506
Mailing address
2305 AARON ST APT 111, PORT CHARLOTTE, FL 33952-5309
(941) 255-9468
(941) 255-9506
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT10549
FL
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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