Individual
JOSEPH DEANOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
(530) 543-5896
(530) 544-6512
Mailing address
PO BOX 9578, SOUTH LAKE TAHOE, CA 96158-9578
(530) 543-5896
(530) 544-6512
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
16-0747
NV
225X00000X
Occupational Therapist
Primary
16427
CA
Other
Enumeration date
03/09/2016
Last updated
03/17/2018
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