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NPI Code Detail

MEDICARE: MISS HEATHER ANN BRUDERECK MSORT/L

MEDICARE: MISS HEATHER ANN BRUDERECK MSORT/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 TherapistOC010776PA

General Provider Information

NPI Number : 1649503210
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS HEATHER ANN BRUDERECK MSORT/L
Provider Business Mailing Address
First Line : 1200 TEL HAI CIR
Second Line :
City : HONEY BROOK
State : PA
Zip : 19344-1271
Country : US
Telephone Number : 610-273-9333
Fax Number : 610-273-3890
Provider Business Practice Location Address
First Line : 1200 TEL HAI CIR
Second Line :
City : HONEY BROOK
State : PA
Zip : 19344-1271
Country : US
Telephone Number : 610-273-9333
Fax Number : 610-273-3890
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2009
Last Update Date : 09/14/2009

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