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Individual

MRS. JODI MARIE RUNK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
6033 BLUE JAY ACRES LN, CASSVILLE, PA 16623-6529
(814) 448-4913
Mailing address
13187 DRYSDALE AVE, PORT CHARLOTTE, FL 33981-2107
(814) 251-3182

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
15540
FL
224Z00000X
Occupational Therapy Assistant
Primary
OP000887L
PA

Other

Enumeration date
09/27/2011
Last updated
05/10/2023
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