Individual
FANNY BRISTOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
115 E TEXAS BLVD, DALHART, TX 79022-4319
(806) 244-0015
Mailing address
PO BOX 18, GRAND ISLAND, NE 68802-0018
(719) 468-0416
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215641
TX
224Z00000X
Occupational Therapy Assistant
933
NE
Other
Enumeration date
07/03/2014
Last updated
11/26/2025
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