Individual
CARLOS AGUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5626 W LAMONA AVE, FRESNO, CA 93722-8606
(559) 477-0387
Mailing address
5626 W LAMONA AVE, FRESNO, CA 93722-8606
(559) 477-0387
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3177
CA
Other
Enumeration date
02/15/2023
Last updated
02/15/2023
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