Individual
ALEXA MEZERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
638 N BROAD ST, ELKHORN, WI 53121-1104
(262) 723-4963
Mailing address
3268 BRIAR CREST DR, JANESVILLE, WI 53546-9603
(608) 445-2258
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057003908
IL
224Z00000X
Occupational Therapy Assistant
Primary
5051-27
WI
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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