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Individual

KEITH PAUL CAVANAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
471 W LAMBERT RD #106, BREA, CA 92821
(714) 255-8877
Mailing address
607 BELLEVIEW AVE, SAN DIMAS, CA 91773-2145
(909) 992-2320

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
24810
CA

Other

Enumeration date
03/20/2023
Last updated
03/20/2023
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