Individual
LORA BRUNKHORST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
102 E J AVE, GRUNDY CENTER, IA 50638-2031
(319) 824-5683
Mailing address
762 RAVEN AVE, GENEVA, IA 50633-7540
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
00637
IA
Other
Enumeration date
07/19/2007
Last updated
07/19/2007
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