Individual
BRIAN A KRAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
W10877 UPPER RED LAKE RD, GRESHAM, WI 54128-8995
(715) 304-6542
Mailing address
PO BOX 424, GRESHAM, WI 54128-0424
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4890-27
WI
Other
Enumeration date
04/20/2012
Last updated
04/20/2012
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