Organization
BRIGHT PATH PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SOMMER LEA MOSSER MS, OTR/L (OCCUPATIONAL THERAPIST)
(701) 721-1200
Entity
Organization
Contact information
Practice address
720 20TH AVE SW, MINOT, ND 58701-6441
(701) 721-1200
Mailing address
200 29TH AVE SE, MINOT, ND 58701-7186
(170) 172-1200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1014
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1461975
—
ND
01
—
1697758449
BLUE CROSS BLUE SHIELD
ND
Enumeration date
09/19/2016
Last updated
10/16/2016
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