| NPI | 1760758023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA M PETRENCHIK Owner And Director 920-740-0128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WI 497626) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |