Individual
MATILDA ANN BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-3100
Mailing address
6023 RED GLITTER ST, NORTH LAS VEGAS, NV 89031-7215
(919) 394-1452
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005281A
IN
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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