Most Relevant Information
Provider Data
| NPI Number: | 1003244633 |
| Provider Name: | JILL DESMOND C.O.T.A./L |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 3219 |
Most Important Dates
| Enumeration Date: | 10/16/2013 |
| Last Updated: | 10/16/2013 |
Provider Practice Location
113 RYANS GATE RD
POMARIA
SC
291268663
Practice Location Phone/Fax
| Phone: | 3523024320 |
| Fax: |
Provider Mailing Location
113 RYANS GATE RD
POMARIA
SC
291268663
Provider Mailing Phone/Fax
| Phone: | 3523024320 |
| Fax: |