Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 7066 | NC |
NPI | 1053550012 |
---|---|
Provider Name | Rhonda Lee Gunderson |
First Address | New Bern, NC 28562-5210 |
Second Address | New Bern, NC 28562-5210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2009 |
Last Update Date | 16/02/2009 |