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1053904961
LARRY EDWIN LICHEY
SAN ANTONIO, TX
NPI
1053904961
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: TX 215748)
Enumeration Date
2021-02-11
Last Update Date
2021-02-11
Business Address
LARRY EDWIN LICHEY COTA
25507 VELVET ROSE
SAN ANTONIO, TX 78260-2491
Phone number: 210-218-4897
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Mailing Address
LARRY EDWIN LICHEY COTA
25507 VELVET ROSE
SAN ANTONIO, TX 78260-2491
Phone number: 210-218-4897
Copy
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