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1013116995
GWENDOLYN M MATUSZ
PORTAGE, IN
NPI
1013116995
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32000822A)
Enumeration Date
2007-07-12
Last Update Date
2007-07-12
Business Address
GWENDOLYN M MATUSZ COTA
6040 LUTE RD
PORTAGE, IN 46368-5008
Phone number: 219-763-6858
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Mailing Address
GWENDOLYN M MATUSZ COTA
2003 CLAREMONT DR
LONG BEACH, IN 46360-1404
Phone number: 219-874-3551
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