Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1598063877 |
---|---|
Provider Name | James Guenther |
First Address | Lake Isabella, MI 48893-9337 |
Second Address | Lake Isabella, MI 48893-9337 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2011 |
Last Update Date | 10/03/2011 |