Individual
BETH ELLEN KOPITZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
6001 ALDERSON ST, SCHOFIELD, WI 54476-3614
(715) 359-4257
Mailing address
6001 ALDERSON ST, SCHOFIELD, WI 54476-3614
(715) 359-4257
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
105-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40563900
—
WI
Enumeration date
07/30/2008
Last updated
08/31/2011
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