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General NPI Number Information
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NPI Number | 1710023163
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Entity Type | Individual
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Provider Name | GAYLE A ROLLMANN OTR
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 3400 E RACINE ST
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City | JANESVILLE
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State | WI
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Zip | 53546-2344
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Country | US
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Telephone | 608-373-8353
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Fax |
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Provider Business Mailing Address
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Address Line | 301 N GEORGE ST
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City | WHITEWATER
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State | WI
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Zip | 53190-1342
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Country | US
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Telephone | 262-473-5102
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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 | 3775-026
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License Number State | WI
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