Individual
MRS. KATHERINE KRISTINE WALTENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4597
(920) 929-2300
Mailing address
114 SOUTHERN EDGE DR, FOND DU LAC, WI 54935-6040
(920) 238-0598
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3611
WI
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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