Individual
MRS. LAURA MICHELE NYSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1425 S MAIN ST, WALNUT CREEK, CA 94596-5318
(925) 295-4030
Mailing address
1316 ENCORE DR, FAIRFIELD, CA 94534-3502
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
15471
CA
Other
Enumeration date
07/27/2022
Last updated
11/05/2022
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