Individual
MR. RAFAEL MADAYAG GUANZON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
6685 E 117TH AVE, CROWN POINT, IN 46307-7808
(219) 663-6392
Mailing address
512 SCENIC VIEW AVE, VALPARAISO, IN 46385-7967
(219) 462-8308
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004394A
IN
Other
Enumeration date
08/07/2008
Last updated
08/07/2008
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