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1407026313
SUMMER LYSE ENNIS
MADISON, WI
NPI
1407026313
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: WI 4624)
Enumeration Date
2008-03-06
Last Update Date
2008-03-06
Business Address
Mrs. SUMMER LYSE ENNIS
600 HIGHLAND AVE COMPLIANCE MAIL CODE 2433
MADISON, WI 53792-0001
Phone number: 608-662-0817
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Mailing Address
Mrs. SUMMER LYSE ENNIS
600 HIGHLAND AVE COMPLIANCE MAIL CODE 2433
MADISON, WI 53792-0001
Phone number: 608-662-0817
Copy
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