Individual
ELLEN GRACE-GOMBAR KRAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4040 BEACON ST, KINGSLEY, MI 49649-9548
(231) 263-1350
Mailing address
4040 BEACON ST, KINGSLEY, MI 49649-9548
(231) 263-1350
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009038
MI
Other
Enumeration date
12/07/2016
Last updated
04/06/2021
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