Individual
MS. CAROL FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1155 N MAYFAIR RD, SPINE CARE CLINIC AT PLANK ROAD, MILWAUKEE, WI 53226-3421
(414) 955-7199
(414) 955-0110
Mailing address
1155 N MAYFAIR RD, SPINE CARE CLINIC AT PLANK ROAD, MILWAUKEE, WI 53226-3421
(414) 955-7199
(414) 955-0110
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1273-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007806261B
HUMANA
—
05
—
40653600
—
WI
Enumeration date
05/16/2006
Last updated
10/04/2012
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