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Individual

MERCEDES LYNN ANTOLAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
310 WEST MAIN STREET, SPARTA, WI 54656-2170
(608) 758-0940
Mailing address
200 1ST STREET SW, ROCHESTER, MN 55905-4054
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5989
MN
225X00000X
Occupational Therapist
Primary
8182-26
WI

Other

Enumeration date
02/07/2023
Last updated
08/25/2023
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