Individual
JACK THOMAS WORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
955 LIBERTY DR, LANCASTER, OH 43130-8045
(740) 653-3193
Mailing address
6098 GLENBARR PL, DUBLIN, OH 43017-9054
(614) 707-2156
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT009899
OH
Other
Enumeration date
08/14/2017
Last updated
08/14/2017
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