Individual
MR. BRIAN WAUTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1225 W PROSPECT RD APT C103, FORT COLLINS, CO 80526-3053
(515) 509-3636
Mailing address
1218 NW VIVION RD, KANSAS CITY, MO 64118-4551
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
07/23/2017
Last updated
07/23/2017
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