Individual
CAMILLE MICHELLE GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1552 MALL DR, IOWA CITY, IA 52240-3110
(319) 351-5437
Mailing address
821 1/2 WEST ST, MANTORVILLE, MN 55955-8056
(507) 384-2916
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
002077
IA
Other
Enumeration date
08/16/2010
Last updated
08/16/2010
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