Most Relevant Information
Provider Data
| NPI Number: | 1003484775 |
| Provider Name: | DALLAN ALTAVILA CRUZ CONSTANTINO OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225XP0200X |
| Specialty: | Occupational Therapist |
| License Number: | 121810 |
Most Important Dates
| Enumeration Date: | 06/17/2021 |
| Last Updated: | 06/17/2021 |
Provider Practice Location
77 NORTH EXPY K
BROWNSVILLE
TX
785267852
Practice Location Phone/Fax
| Phone: | 9565412102 |
| Fax: |
Provider Mailing Location
1165 WILDROSE LN APT 116
BROWNSVILLE
TX
785208802
Provider Mailing Phone/Fax
| Phone: | 9566218438 |
| Fax: |