Individual
MRS. LEA R.C. JAVENKOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
130 STRAWBERRY LN, WISCONSIN RAPIDS, WI 54494-2156
(715) 424-1600
Mailing address
2290 SHADY LN, ROSHOLT, WI 54473-9727
(715) 345-0641
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3838-26
WI
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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