Individual
PATRICIA ELEANOR FONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1703 60TH ST, KENOSHA, WI 53140-3986
(262) 658-4125
Mailing address
3725 SOUTH HERMAN ST., MILWAUKEE, WI 53207
(414) 243-5991
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5492-27
WI
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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