Individual
ABBEY MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
7517 W COLDSPRING RD, GREENFIELD, WI 53220-2814
(414) 327-6603
(414) 327-5411
Mailing address
7517 W COLDSPRING RD, GREENFIELD, WI 53220-2814
(414) 327-6603
(414) 327-5411
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4944-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4944-26
STATE LICENSE
WI
Enumeration date
09/23/2011
Last updated
09/23/2011
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