Individual
CARLO NAGTALON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1240 STACY DR, CANTON, MI 48188-1430
(586) 381-6308
Mailing address
1240 STACY DR, CANTON, MI 48188-1430
(586) 381-6308
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
5201006857
MI
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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