Individual
TRISHA MARIE STORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2705 ENLOE ST, HUDSON, WI 54016-8173
(715) 386-2128
(715) 386-6119
Mailing address
PO BOX 2, 708 RYAN RONALD RD, ROBERTS, WI 54023-0002
(715) 749-4473
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4588
WI
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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