DESTRY ALLEN FRITZ

DELAVAN, WI
NPI1407068612
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: WI  1318-027)
Enumeration Date2007-05-03
Last Update Date2007-07-08
Business Address
Mr. DESTRY ALLEN FRITZ COTA
905 E GENEVA ST
DELAVAN, WI 53115-1922
Phone number: 262-728-1442
Mailing Address
Mr. DESTRY ALLEN FRITZ COTA
W9245 STADER RD
WHITEWATER, WI 53190-4157
Phone number: 262-472-0348
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