Individual
BENITO ALBERTO JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
410 FAIR LN, TIFFIN, OH 44883-2518
(567) 938-0292
Mailing address
695 COUNTY ROAD 12, FREMONT, OH 43420-9642
(419) 355-5452
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002285
OH
Other
Enumeration date
02/24/2022
Last updated
02/24/2022
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