Individual
MRS. ELLEN ANNE DEMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
305 S. CLARK ST., MAYVILLE, WI 53050
(920) 387-1370
(920) 387-2429
Mailing address
N8435 SUNSET BLVD, BEAVER DAM, WI 53916-9733
(920) 273-7947
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2011-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41039400
—
WI
Enumeration date
05/10/2007
Last updated
07/09/2007
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