Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 114758 | TX |
NPI | 1003178310 |
---|---|
Provider Name | Adam Anthony Infante |
First Address | El Paso, TX 79936-2098 |
Second Address | El Paso, TX 79936-2098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2012 |
Last Update Date | 12/06/2012 |