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Individual

CAROL JEAN CHRISTENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 568-5299
Mailing address
N1411 SAINT JOHNS RD, FORT ATKINSON, WI 53538-9656
(920) 563-4650

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
724-026
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40579100
WI
Enumeration date
05/13/2008
Last updated
07/26/2019
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