Individual
JAMIE WITKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1402 MAIN ST, BLOOMER, WI 54724-1637
(715) 568-4669
Mailing address
13249 38TH AVE, CHIPPEWA FALLS, WI 54729-7339
(715) 720-7830
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3021-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40804300
—
WI
Enumeration date
05/23/2007
Last updated
07/08/2007
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