Individual
JOEL THOMAS CEPUKENAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
146 S GRANITE ST, PRESCOTT, AZ 86303-4710
(928) 445-5400
Mailing address
915 JOVIAN DR, PRESCOTT, AZ 86301-1738
(928) 713-9069
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2207
AZ
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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