Individual
LISA M KRUSSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1350 N TODD DR, SCOTTSBURG, IN 47170-7755
(812) 414-2660
(812) 414-2661
Mailing address
1350 N TODD DR, SCOTTSBURG, IN 47170-7755
(812) 414-2660
(812) 414-2661
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001099A
IN
Other
Enumeration date
05/21/2009
Last updated
04/02/2010
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