Most Relevant Information
Provider Data
| NPI Number: | 1003029406 |
| Provider Name: | MANDI ANN HERWIG C.O.T.A. |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 1361-027 |
Most Important Dates
| Enumeration Date: | 05/08/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
323 WEST MONROE STREET
WYOCENA
WI
53969
Practice Location Phone/Fax
| Phone: | 6084292181 |
| Fax: |
Provider Mailing Location
N7584 STONEHAVEN DR
PORTAGE
WI
539019149
Provider Mailing Phone/Fax
| Phone: | 6087423067 |
| Fax: |