Individual
CAROL LYNN BARTZ-BENTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
E5551 STATE ROAD 161, MANAWA, WI 54949-9601
(920) 596-2337
Mailing address
E5551 STATE ROAD 161, MANAWA, WI 54949-9601
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40543300
—
WI
Enumeration date
06/05/2007
Last updated
07/09/2007
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