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NPI Code Detail

MEDICARE: ALESHA BRUNK

MEDICARE: ALESHA BRUNK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist5201007336MI

General Provider Information

NPI Number : 1376020644
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALESHA BRUNK
Provider Business Mailing Address
First Line : 585 E FLINT ST
Second Line :
City : LAKE ORION
State : MI
Zip : 48362-3209
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 585 E FLINT ST
Second Line :
City : LAKE ORION
State : MI
Zip : 48362-3209
Country : US
Telephone Number : 248-693-0505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2018
Last Update Date : 07/19/2018

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Directions to “ ALESHA BRUNK ” Practice Location

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