Individual
LANCE BERESFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L, DRS
Contact information
Practice address
1301 PENN AVE STE 308, DES MOINES, IA 50316-2368
(515) 263-5143
Mailing address
1200 PLEASANT ST, DES MOINES, IA 50309-1406
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
224ZR0403X
Driving and Community Mobility Occupational Therapy Assistant
—
—
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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