Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 15421 | CA |
NPI | 1346648201 |
---|---|
Provider Name | Mr. Adrian Bitowft |
First Address | Long Beach, CA 90807-3717 |
Second Address | Long Beach, CA 90807-3717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2014 |
Last Update Date | 17/03/2018 |