Individual
MR. BARRY LEE BRAESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2525 S 135TH AVE, OMAHA, NE 68144-2424
(402) 333-2304
Mailing address
4117 N 93RD ST, OMAHA, NE 68134-3937
(402) 630-0905
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
311
NE
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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