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Individual

BRIAN LAUBENTHAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
1400 E 2ND ST, DEFIANCE, OH 43512-2440
(419) 783-3309
Mailing address
PO BOX 39, GLANDORF, OH 45848-0039

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
006544
OH

Other

Enumeration date
08/06/2018
Last updated
08/06/2018
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