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Individual

SHANE MEYER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
309 PARK ST, APARTMENT 1, FORT ATKINSON, WI 53538-2167
(715) 220-1767
Mailing address
309 PARK ST, APARTMENT 1, FORT ATKINSON, WI 53538-2167

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5162-27
WI

Other

Enumeration date
06/19/2015
Last updated
06/19/2015
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