Individual
MELISSA S BRUHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 S STATION RD, GLEN CARBON, IL 62034-2743
(618) 946-9010
Mailing address
312 E MILL ST, STAUNTON, IL 62088-1940
(618) 946-9010
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.002068
IL
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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