Most Relevant Information
Provider Data
| NPI Number: | 1003023433 |
| Provider Name: | PAUL JOSEPH DERY C.O.T.A. |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 871-027 |
Most Important Dates
| Enumeration Date: | 05/16/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
2512 NEW PINE DR
ALTOONA
WI
547201378
Practice Location Phone/Fax
| Phone: | 7158330400 |
| Fax: | 7158330397 |
Provider Mailing Location
2149 15TH ST
EAU CLAIRE
WI
547032656
Provider Mailing Phone/Fax
| Phone: | 7158399127 |
| Fax: |