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1427033604
ED A DETELS
NEWPORT BEACH, CA
NPI
1427033604
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: CA OT1096)
Enumeration Date
2005-12-12
Last Update Date
2012-10-18
Business Address
-- ED A DETELS OT
200 NEWPORT CENTER DR #213
NEWPORT BEACH, CA 92660-7501
Phone number: 949-644-1322
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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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