Individual
MICHAEL LYNN MINTUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTA/L
Contact information
Practice address
641 CEDAR AVE, NEOGA, IL 62447-1021
(217) 895-3630
Mailing address
641 CEDAR AVE, NEOGA, IL 62447-1021
(217) 895-3630
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057001191
IL
Other
Enumeration date
08/14/2008
Last updated
08/14/2008
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