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Individual
BRYCE TEALE
Active
Individual
BRYCE TEALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOTRL
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT200310
LA
225XN1300X
Neurorehabilitation Occupational Therapist
OTT200310
LA
Other
Enumeration date
11/25/2013
Last updated
11/25/2013
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