Individual
DAVID JOSEPH BANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2260 BRIDGEPORT CIR, ROCKLEDGE, FL 32955-4344
(321) 427-0046
Mailing address
2260 BRIDGEPORT CIR, ROCKLEDGE, FL 32955-4344
(321) 427-0046
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 17634
FL
Other
Enumeration date
04/07/2016
Last updated
06/04/2018
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