Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 056011981 | IL |
NPI | 1235535493 |
---|---|
Provider Name | Brian C. Junnier |
First Address | Sacramento, CA 95865-5228 |
Second Address | Roseville, CA 95661-3088 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2014 |
Last Update Date | 02/06/2020 |