MR. Al Dg Mandeoya Grande, OTRL

NPI #1093064941 in Wyandotte, Michigan

Provider Information

NPI Number: 1093064941
Entity Type: Individual
Name: MR. Al Dg Mandeoya Grande, OTRL
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: OTRL
Enumeration Date: Sep 6, 2012
Last Updated: Jun 27, 2018

Practice Location

Address: 2333 BIDDLE AVE
City: Wyandotte
State: Michigan
ZIP Code: 48192
Phone: (734) 246-7732

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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