Individual
MR. HORATIO MINTER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
9879 IVY ST, SPRING VALLEY, CA 91977-7031
(619) 985-5538
Mailing address
9879 IVY ST, SPRING VALLEY, CA 91977-7031
(619) 985-5538
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT25785
CA
Other
Enumeration date
12/06/2013
Last updated
12/06/2013
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