ELLISON M KRUCKENBERG

BOUNTIFUL, UT
NPI1386100402
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: UT  12931092-4202)
Enumeration Date2019-02-13
Last Update Date2022-07-12
Business Address
ELLISON M KRUCKENBERG COTA/L
401 S 400 E
BOUNTIFUL, UT 84010-4933
Phone number: 801-295-2361
Mailing Address
ELLISON M KRUCKENBERG COTA/L
9487 S WASATCH DOWNS CIR
SOUTH JORDAN, UT 84095-9289
Phone number: 385-226-9401
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