Individual
KELLY WHALEN BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
426 MCMILLEN ST, FORT ATKINSON, WI 53538-1996
(920) 563-9357
(920) 568-6545
Mailing address
426 MCMILLEN ST, FORT ATKINSON, WI 53538-1996
(920) 563-9357
(920) 568-6545
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2477-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41030100
—
WI
Enumeration date
07/20/2006
Last updated
07/07/2010
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