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Individual

GREGORY CHARLES-SVEDA SUMNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
12940 HARRIET AVE S STE 215, BURNSVILLE, MN 55337-2680
(612) 483-6748
Mailing address
12940 HARRIET AVE S STE 215, BURNSVILLE, MN 55337-2680

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
102036
MN

Other

Enumeration date
05/13/2009
Last updated
05/13/2009
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