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Individual

KATIE MARIE RADIG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS/OTR/L

Contact information

Practice address
845 S MAIN ST, FOND DU LAC, WI 54935-6174
(920) 252-5676
Mailing address
1045 MELISSA ST, MENASHA, WI 54952-2014
(920) 428-5805

Taxonomy

Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
5220-26
WI

Other

Enumeration date
09/06/2012
Last updated
11/20/2018
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