Individual
SOPHIA GRACE BURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 623-7814
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
105988
MN
Other
Enumeration date
05/21/2019
Last updated
05/21/2019
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