NPI 1043488562

Jake Gibbons, OTA

Practitioner Occupational Therapy Assistant Fontanelle, IA

Practice location

Address: 326 Summerset St, Fontanelle, IA 50846-8098
Phone: (615) 896-6400
Fax: (615) 896-5177
Mailing address: 624 W North St, Madrid, IA 50156-1024

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence 00306 (IA)

Other Occupational Therapy Assistant providers in Iowa →

Registry record

NPI: 1043488562
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Feb 2008
Record last updated: 19 Feb 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.