C12 Medical LLC

NPI #1972071801 in Largo, Florida

Provider Information

NPI Number: 1972071801
Entity Type: Organization
Organization Name: C12 Medical LLC
Primary Specialty: Occupational Therapist
Enumeration Date: Nov 8, 2018
Last Updated: Nov 8, 2018

Practice Location

Address: 333 16TH AVE SE
City: Largo
State: Florida
ZIP Code: 33771-4407
Phone: (727) 251-7782

Authorized Official

Name: CHRISTIAN S CHILDERS
Title: OT
Phone: (727) 251-7782

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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