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General NPI Number Information
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NPI Number | 1568623015
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Entity Type | Individual
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Provider Name | LAURA LYNN FUTTERER OTR
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Gender | Female
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 3821 KOHLER MEMORIAL DR
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City | SHEBOYGAN
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State | WI
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Zip | 53081-3680
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Country | US
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Telephone | 920-208-9648
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Fax | 920-208-6316
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Provider Business Mailing Address
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Address Line | 2853 S ELLEN ST
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City | MILWAUKEE
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State | WI
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Zip | 53207-2536
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Country | US
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Telephone | 414-727-9239
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 4646-26
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License Number State | WI
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