LEZERIC ANZEL FALLEN

EVANSVILLE, IN
NPI1194078972
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: IN  32000566A)
Enumeration Date2012-10-18
Last Update Date2012-10-18
Business Address
Mr. LEZERIC ANZEL FALLEN OTA
1157 S KENTUCKY AVE
EVANSVILLE, IN 47714-2737
Phone number: 812-402-0460
Mailing Address
Mr. LEZERIC ANZEL FALLEN OTA
1157 S KENTUCKY AVE
EVANSVILLE, IN 47714-2737
Phone number: 812-402-0460
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