Individual
SAMNANG KHEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
125 DILLMONT DR, COLUMBUS, OH 43235-4658
(614) 844-5433
Mailing address
125 DILLMONT DR, COLUMBUS, OH 43235-4658
(614) 844-5433
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
06172
OH
Other
Enumeration date
08/06/2015
Last updated
08/18/2016
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