Individual
DESERAE BRUNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2921 S MILLWOOD AVE, WICHITA, KS 67217-2443
(316) 708-4573
Mailing address
527 S LONGBRACH DR, MAIZE, KS 67101
(316) 708-4573
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-01315
KS
224Z00000X
Occupational Therapy Assistant
T-04432
KS
Other
Enumeration date
02/07/2016
Last updated
10/14/2021
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