Individual
JIMMY ANTHONY CANALES II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
221 CEDAR DR, PORTLAND, TX 78374-2900
(361) 643-1888
Mailing address
6025 NATCHEZ DR, CORPUS CHRISTI, TX 78414-4164
(361) 877-6411
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
213468
TX
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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