ED A DETELS

NEWPORT BEACH, CA
NPI1427033604
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: CA  OT1096)
Enumeration Date2005-12-12
Last Update Date2012-10-18
Business Address
ED A DETELS OT
200 NEWPORT CENTER DR #213
NEWPORT BEACH, CA 92660-7501
Phone number: 949-644-1322
Mailing Address
ED A DETELS OT
200 NEWPORT CENTER DR #213
NEWPORT BEACH, CA 92660-7501
Phone number: 949-644-1322
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