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Individual

JONATHAN AMELUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
14615 N 33RD AVE, PHOENIX, AZ 85053-4706
(602) 348-6953
Mailing address
14615 N 33RD AVE, PHOENIX, AZ 85053-4706
(602) 348-6953

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5859
AZ

Other

Enumeration date
10/22/2015
Last updated
10/22/2015
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