Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA12932 | FL |
NPI | 1023425113 |
---|---|
Provider Name | Andrew Dunning |
First Address | Homosassa, FL 34446-5028 |
Second Address | Homosassa, FL 34446-5028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2014 |
Last Update Date | 21/07/2014 |