Individual
KRISTEN BORNTREGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
4722 W TILL RD, FORT WAYNE, IN 46818-9310
(260) 433-8826
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003568A
IN
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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