Individual
JEANNE MARIE PRUSAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1280 CHANDLER DRIVE, SPOONER, WI 54801-1201
(715) 635-2111
Mailing address
5736 COUNTY ROAD X, WEBSTER, WI 54893-9046
(715) 566-0398
(715) 866-4788
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3180-026
WI
225XH1200X
Hand Occupational Therapist
3180-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40818000
—
WI
Enumeration date
10/16/2007
Last updated
02/09/2017
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