Individual
AUBREY CORLETTE MENTIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1601 ACADEMY RD, PONCA CITY, OK 74604-4409
(580) 749-5923
(580) 749-5924
Mailing address
228 S FORESTVIEW CT, NONE, WICHITA, KS 67235-8225
(316) 305-5073
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1801136
KS
Other
Enumeration date
02/19/2015
Last updated
02/19/2015
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