TRACY RAE JOHANNECK-UTPHALL

RACINE, WI
NPI1730416769
Former NameTRACY RAE JOHANNECK
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: WI  1193-27)
Enumeration Date2009-11-12
Last Update Date2009-11-12
Business Address
MRS. TRACY RAE JOHANNECK-UTPHALL COTA
3248 SHORTRIDGE DR
RACINE, WI 53402-1367
Phone number: 414-550-6670
Mailing Address
MRS. TRACY RAE JOHANNECK-UTPHALL COTA
3248 SHORTRIDGE DR
RACINE, WI 53402-1367
Phone number: 414-550-6670
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