Individual
LAURIE JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 E SOUTH ST, SOUTH WAYNE, WI 53587-9786
(608) 293-2358
Mailing address
107 E SOUTH ST, SOUTH WAYNE, WI 53587-9786
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.004577
IL
224Z00000X
Occupational Therapy Assistant
Primary
5290-27
WI
Other
Enumeration date
08/02/2016
Last updated
07/24/2017
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