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Individual

DEXTER CERVANTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.T.

Contact information

Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0002
(309) 672-5522
Mailing address
1920 OLD SPRINGVILLE RD, BIRMINGHAM, AL 35215-5858
(205) 520-9600
(205) 520-0455

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008282
IL

Other

Enumeration date
04/15/2009
Last updated
05/31/2011
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