Individual
AUDREY GENEANE SIDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
818 N PINE ST, ISHPEMING, MI 49849-1435
(810) 280-6367
Mailing address
818 N PINE ST, ISHPEMING, MI 49849-1435
(810) 280-6367
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007621
MI
Other
Enumeration date
01/15/2015
Last updated
01/15/2015
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