Individual
GEOFFREY ALAN SUPPLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
3005 LAKEVIEW PKWY STE 400, ROWLETT, TX 75088-3320
(214) 607-9304
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
120102
TX
Other
Enumeration date
06/04/2019
Last updated
07/18/2019
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