Healthcare Provider Details

I. General information

NPI: 1669953808
Provider Name (Legal Business Name): REBECCA LYNNE KUZNAR OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2018
Last Update Date: 08/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 CLINTON ST
MUSKEGON MI
49442-5502
US

IV. Provider business mailing address

4014 DUNES PKWY
NORTON SHORES MI
49441-4491
US

V. Phone/Fax

Practice location:
  • Phone: 231-728-5811
  • Fax:
Mailing address:
  • Phone: 231-759-7285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201004768
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: