Individual
MR. LANCE BERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
390 ELDER ST, YPSILANTI, MI 48197-5103
(734) 657-6120
Mailing address
390 ELDER ST, YPSILANTI, MI 48197-5103
(734) 657-6120
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
10489
CA
225X00000X
Occupational Therapist
Primary
5201006221
MI
Other
Enumeration date
08/17/2010
Last updated
08/17/2010
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