Individual
CARLOS A FONTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ORTL
Contact information
Practice address
126 MILLPORT CIR, SUITE 201, GREENVILLE, SC 29607-5564
(864) 329-1480
(864) 329-8427
Mailing address
126 MILLPORT CIR, SUITE 201, GREENVILLE, SC 29607-5564
(864) 329-1480
(864) 329-8427
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3242
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3242
STATE LICENSE
SC
Enumeration date
07/24/2007
Last updated
07/24/2007
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