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1740496132
SCOTT WADE OLENICZAK
GREEN BAY, WI
NPI
1740496132
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: WI 3259-026)
Enumeration Date
2007-05-15
Last Update Date
2019-10-29
Business Address
SCOTT WADE OLENICZAK
215 N WEBSTER AVE
GREEN BAY, WI 54301-4813
Phone number: 920-431-5588
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Mailing Address
SCOTT WADE OLENICZAK
3446 EDINBURGH RD
GREEN BAY, WI 54311-7284
Phone number:
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