Provider Demographics
NPI:1467052563
Name:KUENZLI, BRYCE (COTA)
Entity Type:Individual
Prefix:
First Name:BRYCE
Middle Name:
Last Name:KUENZLI
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N4753 PRICE POLAR RD
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:WI
Mailing Address - Zip Code:54418-9663
Mailing Address - Country:US
Mailing Address - Phone:715-219-2306
Mailing Address - Fax:
Practice Address - Street 1:207 MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKE ANDES
Practice Address - State:SD
Practice Address - Zip Code:57356-2031
Practice Address - Country:US
Practice Address - Phone:605-487-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant