Individual
MS. RENEE LORRAINE MIDTHUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
12476 W LAKE ST, HAYWARD, WI 54843-5309
(715) 462-4400
Mailing address
12476 W LAKE ST, HAYWARD, WI 54843-5309
(715) 462-4400
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
686-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40518400
—
WI
Enumeration date
05/03/2008
Last updated
05/03/2008
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