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1376004697
TED SANTIAGO PASCO
ORLANDO, FL
NPI
1376004697
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: IL 056012806)
Enumeration Date
2019-03-28
Last Update Date
2019-03-28
Business Address
TED SANTIAGO PASCO
3452 LAKE LYNDA DR STE 200
ORLANDO, FL 32817-1481
Phone number: 800-774-7785
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Mailing Address
TED SANTIAGO PASCO
130 E COX ST APT 3
FORSYTH, IL 62535-8952
Phone number: 407-627-6689
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