Individual
TERESA GORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 2ND ST, NEENAH, WI 54956-2883
(920) 729-3100
Mailing address
1020 PARK RIDGE AVE, OSHKOSH, WI 54901-1592
(920) 235-6079
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2797-26
WI
Other
Enumeration date
08/14/2006
Last updated
09/11/2007
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