Individual
BRIANNA EMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4699 53RD AVE, BETTENDORF, IA 52722
(563) 200-2484
Mailing address
14473 N 900TH AVE, CAMBRIDGE, IL 61238-9381
(309) 721-7121
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.005691
IL
224Z00000X
Occupational Therapy Assistant
Primary
111325
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BE8891
—
IA
Enumeration date
12/08/2021
Last updated
12/08/2021
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