Individual
EILEEN E WATERHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1968 7TH AVE, CHETEK, WI 54728-7605
(715) 837-1598
Mailing address
1968 7TH AVE, CHETEK, WI 54728-7605
(715) 837-1598
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
223012
WI
Other
Enumeration date
05/10/2013
Last updated
05/10/2013
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