Individual
MARY ANNE MCCORMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2749
Mailing address
1570 MIDWAY PL, MENASHA, WI 54952-1165
(920) 720-1464
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1773-027
WI
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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