NPI 1285799312

Rodney B Black, OT

Practitioner Occupational Therapist Tucker, GA

Practice location

Address: 3760 Lavista Rd Suite 102, Tucker, GA 30084-5615
Phone: (404) 248-0415
Fax: (404) 248-0422
Mailing address: 100 Azalea Dr, Fairburn, GA 30213-1705

Registered specialties

Occupational Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225X00000X Licence 0652 (GA)

Other Occupational Therapist providers in Georgia →

Registry record

NPI: 1285799312
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Dec 2006
Record last updated: 8 Jul 2007

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.