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General NPI Number Information
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NPI Number | 1891092953
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Entity Type | Individual
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Provider Name | KRISTINE MUCH OT
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Gender | Female
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 3200 PLEASANT VALLEY RD
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City | WEST BEND
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State | WI
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Zip | 53095-9274
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Country | US
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Telephone | 262-677-6805
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Fax |
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Provider Business Mailing Address
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Address Line | 3385 DRUMLIN DR
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City | SLINGER
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State | WI
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Zip | 53086-9138
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Country | US
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Telephone |
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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 | 2409-26
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License Number State | WI
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