Individual
VINCENT ELMO CANEZAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
5135 OXFORD LN, ONTARIO, CA 91762-7232
(909) 438-5887
Mailing address
5135 OXFORD LN, ONTARIO, CA 91762-7232
(909) 438-5887
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA3767
CA
Other
Enumeration date
03/29/2017
Last updated
03/29/2017
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