Individual
MR. FERDINAND LAWRENCE PILPA BUOT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
50 MARK WEST SPRINGS RD STE 101, SANTA ROSA, CA 95403-1461
(707) 527-0183
Mailing address
1328 RANGE AVE UNIT 206, SANTA ROSA, CA 95401-7039
(707) 536-7634
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
18675
CA
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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