Individual
ANTONIO MARIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4204 E 115TH ST, KANSAS CITY, MO 64137-2416
(816) 405-7071
Mailing address
4204 E 115TH ST, KANSAS CITY, MO 64137-2416
(816) 405-7071
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2010037017
MO
Other
Enumeration date
09/30/2016
Last updated
09/30/2016
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