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Individual

COURTNEY JOY LANGENDORF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
W5528 N SHORE DR, NEW LISBON, WI 53950-9034
(608) 547-1518
Mailing address
W5528 N SHORE DR, NEW LISBON, WI 53950-9034

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5506-27
WI
224Z00000X
Occupational Therapy Assistant

Other

Enumeration date
07/02/2019
Last updated
07/02/2019
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