Individual
ALTA GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
508 LYNNEHAVEN DR, APT. L, HAGERSTOWN, MD 21742-4167
(240) 500-6406
Mailing address
508 LYNNEHAVEN DR, APT.L, HAGERSTOWN, MD 21742-4167
(240) 500-6406
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
07030
MD
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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