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Individual

CHAD ROMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1201 34TH ST, SAN DIEGO, CA 92102-2416
(619) 232-2946
Mailing address
10855 NW 1ST ST, PEMBROKE PINES, FL 33026-4090
(305) 780-4279

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA3618
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
OTA3618
CA
Enumeration date
12/09/2016
Last updated
12/09/2016
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