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1972157840
JACOB E LANZENDORF
GREEN BAY, WI
NPI
1972157840
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: WI 6589-26)
Enumeration Date
2019-07-30
Last Update Date
2022-11-02
Business Address
JACOB E LANZENDORF OT
1970 S RIDGE RD
GREEN BAY, WI 54304-4125
Phone number: 920-430-4888
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Mailing Address
JACOB E LANZENDORF OT
PO BOX 22487
GREEN BAY, WI 54305-2487
Phone number: 920-445-7210
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