Individual
MS. ANNA LEIGH KOONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
512 BEACH ST, FENTON, MI 48430-3122
(810) 629-4117
Mailing address
7034 HICKORY ST, FLUSHING, MI 48433-9036
(810) 265-5611
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009236
MI
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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