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General NPI Number Information
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NPI Number | 1730699166
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Entity Type | Individual
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Provider Name | JAROM ARTHUR RICKS OTR/L
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Gender | Male
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 10/12/2017
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Provider Practice Location Address
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Address Line | 16690 SW CHIPOLA RD
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City | BLOUNTSTOWN
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State | FL
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Zip | 32424-1953
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Country | US
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Telephone | 850-674-4311
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Fax |
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Provider Business Mailing Address
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Address Line | 7997 NW 90TH AVE
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City | OCALA
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State | FL
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Zip | 34482-1910
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Country | US
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Telephone | 661-703-3629
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT18715
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License Number State | FL
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