Individual
MR. GUY ADRIEN HOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
12170 CORTEZ BLVD, BROOKSVILLE, FL 34613-5578
(352) 597-5100
Mailing address
25442 WILLOW ST, BROOKSVILLE, FL 34601-4724
(352) 587-4692
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 13774
FL
Other
Enumeration date
09/08/2014
Last updated
09/08/2014
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