Healthcare Provider Details

I. General information

NPI: 1144433483
Provider Name (Legal Business Name): SHERRI VOGT OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHERRI ELLEFSON OTR

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36500 AURORA DR
SUMMIT WI
53066
US

IV. Provider business mailing address

36500 AURORA DR
SUMMIT WI
53066
US

V. Phone/Fax

Practice location:
  • Phone: 262-434-2600
  • Fax: 262-434-2601
Mailing address:
  • Phone: 262-434-2600
  • Fax: 262-434-2601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4239026
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: