Individual
MS. TINA MICHELLE BURTARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., OTR/L
Contact information
Practice address
2600 KILEY WAY, PLYMOUTH, WI 53073-5020
(920) 459-1409
Mailing address
5433 W NATIONAL AVE, APT. 211 A, WEST MILWAUKEE, WI 53214-3452
(920) 980-1818
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
4488
AZ
225X00000X
Occupational Therapist
Primary
—
WI
Other
Enumeration date
03/08/2010
Last updated
04/12/2011
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