Andy Gillum, COTA

NPI 1003047812 · on the registry since 2009 · sole proprietor

Practice

Address: 2125 Royce St
Portsmouth, OH 45662
Phone: (740) 876-9232
Fax: (740) 876-9525
Organisation at this address: Royce Leasing Co., Llc
Thi Of Ohio At Golden Years Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 12

Registry record

Primary taxonomy: 224Z00000X
224Z00000X
Licence states on file: OH
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2009-07-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio