Individual
MR. OWEN TANADA TABELISMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
788 DUNBAR HILL RD, GRANTHAM, NH 03753-3231
(609) 224-3952
Mailing address
788 DUNBAR HILL RD, GRANTHAM, NH 03753-3231
(609) 224-3952
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
072.0077349
VT
Other
Enumeration date
09/18/2014
Last updated
01/13/2015
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