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Individual

CALVIN TAMBULO CAMOT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, OTR/L

Contact information

Practice address
8512 CRAGGAN LN, MANASSAS, VA 20109-4289
(703) 901-8711
Mailing address
8512 CRAGGAN LN, MANASSAS, VA 20109-4289
(703) 901-8711

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119007899
VA
225X00000X
Occupational Therapist
Primary
023244
NY

Other

Enumeration date
01/30/2019
Last updated
01/30/2019
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