Individual
MRS. MELANIE LYNN RECORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2021 S. ALVERNO ROAD, MANITOWOC, WI 54220-9208
(920) 683-4592
Mailing address
16625 EVENSON RD, VALDERS, WI 54245-9759
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6625-26
WI
225XG0600X
Gerontology Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100102503
—
WI
Enumeration date
10/21/2019
Last updated
07/15/2021
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