Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 1230 | ND |
NPI | 1972908572 |
---|---|
Provider Name | Kurran Opp |
First Address | Bismarck, ND 58503-0431 |
Second Address | Bismarck, ND 58503-0431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2014 |
Last Update Date | 27/10/2014 |