Individual
MRS. SHELLY ANN LANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5595 COUNTY ROAD Z, WEST BEND, WI 53095-9224
(262) 306-2100
(262) 306-2128
Mailing address
410 WASHINGTON AVE, KEWASKUM, WI 53040-8902
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3350026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40860100
—
WI
Enumeration date
11/06/2006
Last updated
07/09/2007
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