Individual
MS. ALYSSA MARIE BRUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
700 N WALNUT ST, NORMAL, IL 61761
(815) 252-5625
Mailing address
700 N WALNUT ST, NORMAL, IL 61761-1753
(815) 252-5625
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.010674
IL
Other
Enumeration date
10/10/2014
Last updated
10/10/2014
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