Individual
MARY C VAN SANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTL
Contact information
Practice address
2901 DETROIT AVE, KINGMAN, AZ 86401-4227
(928) 753-6413
Mailing address
3756 E NICOLE AVE, KINGMAN, AZ 86409-0830
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0510
AZ
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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