MEDICARE: BRIANNA LANDRUM 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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1730843236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA LANDRUM OTR/L

Provider Business Mailing Address
First Line	:	5069 PICASSO DR
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-4674
Country	:	US
Telephone Number	:	909-539-3328
Fax Number	:

Provider Business Practice Location Address
First Line	:	5069 PICASSO DR
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-4674
Country	:	US
Telephone Number	:	909-539-3328
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2021
Last Update Date	:	11/14/2023

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