Individual
ANN V. JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4922 COLUMBIA RD, CEDARBURG, WI 53012-9188
(262) 377-4077
(262) 377-7358
Mailing address
4922 COLUMBIA RD, CEDARBURG, WI 53012-9188
(262) 377-4077
(262) 377-7358
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1166
WI
225XE1200X
Ergonomics Occupational Therapist
1166
WI
225XH1200X
Hand Occupational Therapist
1166
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
391550272010
BCBS GROUP BILLING NUMBER
WI
05
—
40643000
—
WI
01
—
41213500
MEDICAID GROUP #
WI
Enumeration date
10/17/2007
Last updated
10/17/2007
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