Individual
MYRANDA RUNNEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1037 19TH ST SW, MASON CITY, IA 50401-6436
(641) 423-0428
Mailing address
1305 330TH ST, FOREST CITY, IA 50436-8062
(641) 590-1559
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
111236
IA
Other
Enumeration date
10/13/2021
Last updated
10/13/2021
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