Individual
MELANIE GRACE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5979 SIGGELKOW RD, MC FARLAND, WI 53558-9817
(608) 838-8999
Mailing address
101 METRO TER UNIT 109, MADISON, WI 53718-6424
(608) 243-9242
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5155-26
WI
Other
Enumeration date
03/08/2012
Last updated
03/08/2012
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