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Individual

GARRY KOVTUN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
6169 S JOG RD STE A11, LAKE WORTH, FL 33467-6586
(561) 432-0111
(561) 432-1075
Mailing address
5840 CORPORATE WAY STE 101, WEST PALM BEACH, FL 33407-2040
(561) 432-0111
(561) 432-1075

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
018927-1
NY
225X00000X
Occupational Therapist
Primary
21438
FL
225X00000X
Occupational Therapist
46TR00658800
NJ
225XH1200X
Hand Occupational Therapist
16557
CA

Other

Enumeration date
07/28/2014
Last updated
02/14/2022
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