Individual
VIVI Y RADTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1 ARBOR TER, FENTON, MO 63026-3900
(636) 343-0016
(636) 343-4794
Mailing address
1 ARBOR TER, FENTON, MO 63026-3900
(636) 343-0016
(636) 343-4794
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
004927
MO
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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