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Individual

VICTORIA J MAGNAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
145 RIVERLAWN AVE, WATERTOWN, WI 53094-4013
(920) 285-2953
Mailing address
145 RIVERLAWN AVE, WATERTOWN, WI 53094-4013
(920) 285-2953

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2435
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1407999832
MEDICARE NPI
WI
01
WI2143001
MEDICARE PTAN
WI
Enumeration date
02/15/2007
Last updated
04/20/2015
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