Individual
MARY GUTZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2895 S MOORLAND RD, NEW BERLIN, WI 53151-3743
(262) 782-9015
Mailing address
536 N 54TH ST, MILWAUKEE, WI 53208-3005
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
109899
TX
225X00000X
Occupational Therapist
Primary
2070-26
WI
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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