Individual
AMY SUE VLOSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3300 W BREWSTER ST, APPLETON, WI 54914-6444
(920) 832-1657
Mailing address
1027 S WALDEN AVE, APPLETON, WI 54915-3742
(920) 419-4129
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4574027
WI
Other
Enumeration date
01/15/2010
Last updated
10/24/2012
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