Individual
TRACI WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
507 S MAIN ST, VIROQUA, WI 54665-2059
(608) 790-5200
Mailing address
507 S MAIN ST, VIROQUA, WI 54665-2059
(608) 790-5200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3439-26
WI
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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