Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 976 | OH |
NPI | 1063825370 |
---|---|
Provider Name | Anton Zopel X |
First Address | Canton, OH 44709-2312 |
Second Address | Canton, OH 44709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2014 |
Last Update Date | 04/06/2014 |