Individual
TRACEY MICHELLE BRUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
685 RIVER AVE, LAKEWOOD, NJ 08701-5228
(732) 364-3772
Mailing address
1895 BREAKERS DR, MANAHAWKIN, NJ 08050-4720
(609) 698-3759
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00387000
NJ
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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