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1457982910
ALEXA ROSE WISTENBERG
GREEN BAY, WI
NPI
1457982910
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: WI 6530-26)
Enumeration Date
2020-02-03
Last Update Date
2020-02-03
Business Address
ALEXA ROSE WISTENBERG OT
744 S WEBSTER AVE
GREEN BAY, WI 54301-3505
Phone number: 920-433-7822
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Mailing Address
ALEXA ROSE WISTENBERG OT
PO BOX 22487
GREEN BAY, WI 54305-2487
Phone number: 920-445-7222
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