Individual
MRS. JEANETTE H. KORNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
80 DUNE HILL LN, GREAT FALLS, MT 59404-6439
(406) 727-4635
Mailing address
80 DUNE HILL LN, GREAT FALLS, MT 59404-6439
(406) 727-4635
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
258
MT
Other
Enumeration date
05/21/2008
Last updated
12/03/2012
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