Individual
JENNIFER A. THAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
11451 52ND ST S, WISCONSIN RAPIDS, WI 54494-9541
(715) 325-6023
Mailing address
11451 52ND ST S, WISCONSIN RAPIDS, WI 54494-9541
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
126-26
WI
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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