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General NPI Number Information
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NPI Number | 1255858130
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Entity Type | Individual
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Provider Name | HOLLY BRECHEISEN MOT/L
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Gender | Female
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Dates
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Enumeration Date | 08/23/2017
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 104 S WASHINGTON ST
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City | JUNCTION CITY
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State | KS
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Zip | 66441-3557
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Country | US
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Telephone | 785-210-3363
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Fax | 785-210-3419
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Provider Business Mailing Address
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Address Line | PO BOX 490
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City | JUNCTION CITY
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State | KS
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Zip | 66441-0490
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Country | US
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Telephone | 785-210-3363
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 17-01882
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License Number State | KS
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