Individual
MS. KATHY RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13111 N PORT WASHINGTON RD, MEQUON, WI 53097-2416
(262) 243-7465
Mailing address
N102W15426 VENUS CT, GERMANTOWN, WI 53022-5227
(262) 253-9376
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1762-027
WI
Other
Enumeration date
06/04/2006
Last updated
07/08/2007
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