Individual
BROOK ANTONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
04915 64TH ST, SOUTH HAVEN, MI 49090-7323
(269) 929-5764
Mailing address
04915 64TH ST, SOUTH HAVEN, MI 49090-7323
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010018
MI
Other
Enumeration date
03/15/2018
Last updated
04/30/2024
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