Individual
IAN BLAKE SOTOMAYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, OTR/L
Contact information
Practice address
163 VAN BUREN RD, CARIBOU, ME 04736-3567
(207) 498-1618
(207) 498-1653
Mailing address
163 VAN BUREN RD STE 1, CARIBOU, ME 04736-3567
(207) 498-1618
(207) 498-1653
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3755
ME
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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