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MR. KENT C. SHIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
640 WORTH ST, CORRY, PA 16407-8515
(814) 664-3830
Mailing address
334 WELLMAN RD, ASHVILLE, NY 14710-9624
(716) 640-2888

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006343
PA

Other

Enumeration date
09/29/2009
Last updated
09/29/2009
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