Individual
SHAUN KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
301 MAIN ST, SUITE 3, GOSHEN, NY 10924-1636
(845) 458-8661
Mailing address
301 MAIN ST, SUITE 3, GOSHEN, NY 10924-1636
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008370-1
NY
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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