Individual
LODIA A RUNCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
29829 TELEGRAPH RD, SUITE 201, SOUTHFIELD, MI 48034-1330
(248) 352-4263
(248) 352-2915
Mailing address
PO BOX 523, JENISON, MI 49429-0523
(616) 457-4919
(616) 457-5261
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201001703
MI
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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