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DAVID JOSEPH BANTA OTR/L

Pediatrics >> Occupational Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1013371806

Individual Registrant:
 DAVID JOSEPH BANTA OTR/L
Gender: M
Sole Proprietor

Location and contact information for practice:
2260 BRIDGEPORT CIR  ROCKLEDGE, FL 32955-4344 US
Tel: 321-427-0046  Fax: --

Contact information for business:
2260 BRIDGEPORT CIR  ROCKLEDGE, FL 32955-4344 US
Tel: 321-427-0046  Fax: --

Registration Information:
NPI: 1013371806
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapist
Pediatrics
FLOT 17634

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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