Individual
MRS. COLLEEN MARY LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2300 STATE ROAD 44, OSHKOSH, WI 54904-9137
(920) 233-2373
Mailing address
N5232 SUMMIT CT, FOND DU LAC, WI 54935-9689
(920) 922-6121
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2993026
WI
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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