Individual
MR. JAMES WALKER PENLAND JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2414 CAMELOT DR, AUGUSTA, GA 30904-3327
(706) 736-0867
Mailing address
2414 CAMELOT DR, AUGUSTA, GA 30904-3327
(706) 736-0867
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
001090
GA
224Z00000X
Occupational Therapy Assistant
0131000520
VA
224Z00000X
Occupational Therapy Assistant
1785
TN
224Z00000X
Occupational Therapy Assistant
2772
SC
Other
Enumeration date
12/22/2009
Last updated
12/22/2009
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