Individual
JACK HOLEVATZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1635 MAPLE LN, ASHLAND, WI 54806-3610
(715) 685-5400
(715) 685-5102
Mailing address
1635 MAPLE LN, ASHLAND, WI 54806-3610
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6525-26
WI
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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