Individual
LAURA BENTRUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
6300 67TH ST, KENOSHA, WI 53142-1437
(262) 652-5372
(262) 652-5372
Mailing address
6300 67TH ST., KENOSHA, WI 53142
(262) 484-4724
(262) 484-4445
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5079-26
WI
Other
Enumeration date
09/14/2011
Last updated
07/28/2015
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