Individual
MICHELLE N. BACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
317 KNUTSON DR, MADISON, WI 53704-1133
(608) 301-9387
Mailing address
317 KNUTSON DR, MADISON, WI 53704-1133
(608) 301-9387
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2523-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40884800
—
WI
Enumeration date
11/01/2006
Last updated
01/28/2021
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