Individual
MRS. LORI JO BANSEMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS.OTR,CHT
Contact information
Practice address
709 SPRING VALLEY RD, BURLINGTON, WI 53105-3622
(262) 971-9314
(262) 971-9301
Mailing address
709 SPRING VALLEY RD, BURLINGTON, WI 53105-7614
(262) 971-9314
(262) 971-9301
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1389-026
WI
Other
Enumeration date
08/16/2007
Last updated
10/31/2016
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