Individual
MR. TODD MATTHEW ANDRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1050 CIRCLE DR, SUITE B, GREEN BAY, WI 54304-5568
(920) 497-1515
(920) 497-1513
Mailing address
1050 CIRCLE DR, SUITE B, GREEN BAY, WI 54304-5568
(920) 497-1515
(920) 497-1513
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2768-26
WI
225XE1200X
Ergonomics Occupational Therapist
2768-026
WI
Other
Enumeration date
12/03/2007
Last updated
05/11/2022
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