Individual
MS. SAMANTHA SPORLEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
2195 N SUMMIT VILLAGE WAY, OCONOMOWOC, WI 53066-8675
(262) 560-2400
(262) 560-0563
Mailing address
2195 N SUMMIT VILLAGE WAY, OCONOMOWOC, WI 53066-8675
(262) 560-2400
(262) 560-0563
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4762-027
WI
Other
Enumeration date
07/15/2010
Last updated
07/15/2010
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