Individual
TAM LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOT
Contact information
Practice address
820 COTTAGE ST NE, SALEM, OR 97301-2426
(954) 338-8262
Mailing address
4316 SW 21ST LN, GAINESVILLE, FL 32607-3815
(954) 338-8262
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
359551
OR
283X00000X
Rehabilitation Hospital
—
—
Other
Enumeration date
01/04/2017
Last updated
09/17/2019
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