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Individual

ANTONIO MALDONADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTA

Contact information

Practice address
2017 W WOODLAND ST, SPRINGFIELD, MO 65807-5913
(417) 889-4800
(417) 889-0980
Mailing address
2017 W WOODLAND ST, SPRINGFIELD, MO 65807-5913
(417) 889-4800

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2012026727
MO

Other

Enumeration date
11/03/2015
Last updated
11/03/2015
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