Individual
MR. TEVIN BRUNSWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
7723 JASPER AVE, JACKSONVILLE, FL 32211-7719
(904) 725-8044
Mailing address
2502 CANEY OAKS DR N, JACKSONVILLE, FL 32218-9087
(904) 708-9753
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16861
FL
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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