Individual
MICHELLE R OETKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
710 RIVERSIDE DR, WAUPACA, WI 54981
(715) 256-3062
Mailing address
PO BOX 8003, APPLETON, WI 54912
(920) 996-3298
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1184
WI
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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