Individual
ANDREW E GOTTHEARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L, CHT
Contact information
Practice address
10320 75TH ST STE D, KENOSHA, WI 53142-7525
(800) 974-4378
(630) 515-1536
Mailing address
24014 W RENWICK RD UNIT 206, PLAINFIELD, IL 60544-8711
(009) 744-3788
(630) 515-1536
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4342-26
WI
Other
Enumeration date
04/20/2007
Last updated
09/20/2024
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