Individual
MICHAEL MAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
3981 S SUNRISE AVE, ONTARIO, CA 91761-2754
(909) 263-3339
Mailing address
3981 S SUNRISE AVE, ONTARIO, CA 91761-2754
(909) 263-3339
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5616
CA
Other
Enumeration date
04/06/2023
Last updated
04/06/2023
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