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Individual

MRS. KIM M FLECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
845 SOUTH MAIN STREET, SUITE 120, FOND DU LAC, WI 54935
(920) 322-0447
(920) 322-1362
Mailing address
845 SOUTH MAIN STREET, SUITE 120, FOND DU LAC, WI 54935
(920) 322-0447
(920) 322-1362

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1471-026
WI
225X00000X
Occupational Therapist
Primary
1471-028
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40727200
WI
Enumeration date
02/19/2007
Last updated
02/23/2010
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