Individual
MRS. JANELLE RAE BRUNGARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2241 NORTHWEST STREET, CARROLL, IA 51401
(712) 792-9284
Mailing address
2241 NORTHWEST STREET, CARROLL, IA 51401
(712) 792-9284
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000777
IA
Other
Enumeration date
10/24/2007
Last updated
10/24/2007
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