Individual
IRENE LIM LO SUY COMSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
710 BROADRIDGE DR, JACKSON, MO 63755-3042
(573) 243-3101
Mailing address
710 BROADRIDGE DR, JACKSON, MO 63755-3042
(573) 243-3101
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
2007030520
MO
Other
Enumeration date
04/16/2016
Last updated
04/16/2016
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