| NPI | 1003094996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA J BRADEN Occupational Therapist 262-206-1567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: IL 056-007841) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: IL 070-001063) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: IL 070-010362) | |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2008-02-04 |