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Individual

MRS. THERESA LYNN BRUNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
2209 STONEHILL ROAD, JEFFERSON CITY, MO 65101
(573) 634-3070
(573) 636-3247
Mailing address
110 PALISADES DR, JEFFERSON CITY, MO 65109-6180
(573) 761-5721

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC002922
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
478224801
MO
Enumeration date
01/23/2007
Last updated
11/05/2025
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