CHARLES JOHN DESTRA

MEADOWBROOK, PA
NPI1164707683
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: PA  OC005061L)
Enumeration Date2011-10-16
Last Update Date2011-10-16
Business Address
Mr. CHARLES JOHN DESTRA OTR/L
1616 HUNTINGDON PIKE
MEADOWBROOK, PA 19046-8001
Phone number: 215-938-4000
Mailing Address
Mr. CHARLES JOHN DESTRA OTR/L
711 PECAN DR
PHILADELPHIA, PA 19115-2817
Phone number: 215-961-2528
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