Organization · Type 2 NPI

Wisconsin Center for Myofascial Release, SC

Occupational Therapist · Kenosha, WI

NPI number 1104042902 Active

Practice location

4103 60th St
Kenosha, WI 53144-2509

Fax (262) 652-1124

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000X3534-026 (WI)

Occupational Therapist: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork…

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About NPI 1104042902

Wisconsin Center for Myofascial Release, SC's National Provider Identifier is 1104042902, issued on Apr 18, 2007. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in Kenosha, WI. The record was last updated on Aug 26, 2013.