Individual
MRS. KRISTIE KATHRYN BUNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
804 STATE ST, SUITE 5, QUINCY, IL 62301-4951
(217) 224-1750
(217) 224-0403
Mailing address
804 STATE ST, SUITE 5, QUINCY, IL 62301-4951
(217) 224-1750
(217) 224-0403
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.006055
IL
225X00000X
Occupational Therapist
2000175651
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KC79160401P
EARLY INTERVENTION
IL
Enumeration date
03/17/2007
Last updated
03/04/2010
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