Individual
MARVIN CRISOSTOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
200 SAND CREEK HWY, ADRIAN, MI 49221-1255
(517) 265-8355
Mailing address
4312 CHERRY BLOSSOM DR, YPSILANTI, MI 48197-4002
(734) 353-8516
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201011345
MI
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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