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NPI Code Detail

MEDICARE: MRS. MONICA BREWER BRUNSON OTR/L

MEDICARE: MRS. MONICA BREWER BRUNSON OTR/L
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 Therapist2666SC

General Provider Information

NPI Number : 1326282930
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MONICA BREWER BRUNSON OTR/L
Provider Business Mailing Address
First Line : 55 KILLARNEY LN
Second Line :
City : SUMTER
State : SC
Zip : 29150-7050
Country : US
Telephone Number : 803-481-5699
Fax Number :
Provider Business Practice Location Address
First Line : 2825 CARTER RD
Second Line :
City : SUMTER
State : SC
Zip : 29150-1712
Country : US
Telephone Number : 803-469-4032
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2009
Last Update Date : 04/27/2009

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Directions to “ MRS. MONICA BREWER BRUNSON OTR/L” Practice Location

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