Individual
COREY JEAN BRUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1451 BLUESTEM BLVD, ALTOONA, WI 54720
(715) 579-5621
Mailing address
18200 51ST AVE, CHIPPEWA FALLS, WI 54729-6838
(715) 579-5621
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5219-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114279098
—
WI
Enumeration date
10/03/2012
Last updated
08/03/2022
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