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Individual

ROSE BAVLNKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
W202N10223 LANNON RD, GERMANTOWN, WI 53022-9545
(262) 366-9088
Mailing address
W202N10223 LANNON RD, GERMANTOWN, WI 53022-9545
(262) 366-9088

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1036-26
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40523200
WI
Enumeration date
11/24/2009
Last updated
11/24/2009
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