Individual
MRS. MICHELLE LEE RUNGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3520 CHOUTEAU AVE, SAINT LOUIS, MO 63103-2916
(314) 771-2100
Mailing address
611 CHANCELLOR LN, FENTON, MO 63026-5466
(636) 305-9367
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2001010317
MO
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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