Individual
MS. CONNNIE SUE BRUSHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
170 PINECREST DR, GALLIPOLIS, OH 45631-1347
(740) 446-7112
(740) 446-9088
Mailing address
526 E 3RD ST, WAVERLY, OH 45690-1226
(740) 708-4456
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 00625
OH
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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