Individual
TERI J THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
101 SUNSHINE BLVD, SOLDIERS GROVE, WI 54655-7106
(608) 624-5127
Mailing address
532 LYNN DR, WEST SALEM, WI 54669-1929
(608) 780-1616
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2004-027
WI
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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