Individual
LEAH MARIE BUNTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6960 IL-162, MARYVILLE, IL 62062
(618) 288-2211
Mailing address
6960 IL-162, MARYVILLE, IL 62062
(618) 288-2211
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056015303
IL
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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