Provider Demographics
NPI:1386479343
Name:BRUNS, LAWRENCE KAMEHAMEHA (OTR/L)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:KAMEHAMEHA
Last Name:BRUNS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:LAWRENCE
Other - Middle Name:KAMEHAMEHA
Other - Last Name:TUCCIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5565 INDIAN MOUND RD
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-7914
Mailing Address - Country:US
Mailing Address - Phone:864-684-3721
Mailing Address - Fax:
Practice Address - Street 1:100 HEALTHY WAY STE 1200
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-7916
Practice Address - Country:US
Practice Address - Phone:864-512-6140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCOT.7318OT225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist