Individual
MRS. KATHRYN C MANTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5700 W LAYTON AVE, GREENFIELD, WI 53220-4016
(414) 281-7200
(414) 281-7200
Mailing address
5700 W LAYTON AVE, GREENFIELD, WI 53220-4016
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2035-27
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41056900
—
WI
Enumeration date
04/08/2008
Last updated
04/08/2008
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