Individual
MR. JASPER S BANZON
Active
Individual
MR. JASPER S BANZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1092
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1092
OCCUPATIONAL THERAPY LIC
WV
01
—
KY-R2967
OCCUPATIONAL THERAPY LIC
KY
Enumeration date
04/02/2007
Last updated
09/09/2013
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