Individual
TERRI JENNIFER TOMICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
216 N CHATHAM ST, JANESVILLE, WI 53548-3598
(608) 774-0734
Mailing address
216 NORTH CHATHAM STREET, JANESVILLE, WI 53548
(608) 774-0734
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5087-26
WI
Other
Enumeration date
10/12/2011
Last updated
11/02/2011
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