Individual
MR. JAVIER E MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
216 NORTH 2ND STREET, AMITE, LA 70422
(985) 748-7878
(985) 748-2837
Mailing address
PO BOX 398, 216 NORTH 2ND STREET, AMITE, LA 70422
(985) 748-7878
(985) 748-2837
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OTT.211550
LA
Other
Enumeration date
12/09/2016
Last updated
12/09/2016
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