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Organization

OT CLINICAL GROUP CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DORIS VEGA VILLAVICENCIO MPH,OTR/L (PRESIDENTA)
(787) 785-9683
Entity
Organization

Contact information

Practice address
SS3 CALLE 35, URB. SANTA JUANITA, BAYAMON, PR 00956-4748
(787) 785-9683
(787) 785-9683
Mailing address
SS3 CALLE 35, URB. SANTA JUANITA, BAYAMON, PR 00956-4748
(787) 785-9683
(787) 785-9683

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
422
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
890461
MMM
PR
Enumeration date
02/02/2006
Last updated
07/02/2008
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