Individual
MRS. HEIDI JO VAN TOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1335 S ONEIDA STREET, APPLETON, WI 54915
(920) 731-6646
Mailing address
W2469 PINE RD, APPLETON, WI 54915
(920) 731-6646
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2407026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40836900
—
WI
Enumeration date
07/17/2008
Last updated
07/17/2008
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