Individual
CHRISTOPHER MANLY DECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
5795 CHESTNUT AVE, BUNNELL, FL 32110
(386) 586-2840
Mailing address
5795 CHESTNUT AVE, BUNNELL, FL 32110
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12002
FL
Other
Enumeration date
04/27/2012
Last updated
04/27/2012
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