Individual
BRIAN CARMONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
700 STEWART RD, MONROE, MI 48162-5304
(734) 240-1820
Mailing address
1470 BUD AVE, YPSILANTI, MI 48198-3309
(937) 307-4788
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010045
MI
Other
Enumeration date
03/30/2018
Last updated
03/30/2018
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