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NPI Code Detail

MEDICARE: ANN ANDERSEN OTR/L

MEDICARE: ANN ANDERSEN OTR/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
1225X00000XOccupational Therapist2604-026WI

General Provider Information

NPI Number : 1346413135
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN ANDERSEN OTR/L
Provider Business Mailing Address
First Line : 8274 E SAN RD
Second Line :
City : SOUTH RANGE
State : WI
Zip : 54874-8621
Country : US
Telephone Number : 715-398-3523
Fax Number :
Provider Business Practice Location Address
First Line : 8274 E SAN RD
Second Line :
City : SOUTH RANGE
State : WI
Zip : 54874-8621
Country : US
Telephone Number : 715-398-3523
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2008
Last Update Date : 04/11/2008

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Directions to “ ANN ANDERSEN OTR/L” Practice Location

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