MEDICARE: ERIKA KRZMARZICK COTA/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant		WI

General Provider Information

NPI Number	:	1174270896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA KRZMARZICK COTA/L

Provider Business Mailing Address
First Line	:	123 HATTEN AVE
Second Line	:
City	:	RICE LAKE
State	:	WI
Zip	:	54868-2028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 RIVER AVE S
Second Line	:
City	:	PRAIRIE FARM
State	:	WI
Zip	:	54762-9791
Country	:	US
Telephone Number	:	715-455-1178
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2022
Last Update Date	:	03/02/2022

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Directions to “ ERIKA KRZMARZICK COTA/L” Practice Location

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