Individual
KIMBERLY GRYZKEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3576 NU ROC LN, LAONA, WI 54541-9291
(715) 674-4477
Mailing address
1218 LITTLE BEAR LN, WABENO, WI 54566-9024
(262) 306-7923
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1043-27
WI
Other
Enumeration date
11/22/2017
Last updated
11/22/2017
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