Individual
MELINDA J BRUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
240 W TYRONE RD, OAK RIDGE, TN 37830-6517
(865) 276-3852
Mailing address
225 HOLDER CEMETERY RD, TELLICO PLAINS, TN 37385-5997
(865) 309-5658
(423) 261-2159
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
197786
TN
225X00000X
Occupational Therapist
Primary
000339
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446652
—
TN
01
—
3156797
BCBST - GROUP NUMBER
TN
05
—
5441442
—
TN
Enumeration date
05/25/2006
Last updated
01/13/2022
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