Individual
MARY BRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
3320 HEMLOCK LN APT 632, MIAMISBURG, OH 45342-5376
(513) 706-2084
Mailing address
3320 HEMLOCK LN APT 632, MIAMISBURG, OH 45342-5376
(513) 706-2084
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003075
OH
Other
Enumeration date
08/03/2014
Last updated
08/03/2014
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