Individual
MRS. TRACEY COSTON BLOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1102 SMITH AVE, SUITE C, THOMASVILLE, GA 31792-5739
(229) 227-1433
(229) 226-6353
Mailing address
1102 SMITH AVE, SUITE C, THOMASVILLE, GA 31792-5739
(229) 227-1433
(229) 226-6353
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105853
TX
225X00000X
Occupational Therapist
OT005242
GA
Other
Enumeration date
10/30/2010
Last updated
12/08/2011
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