Individual
MS. ELIZABETH VISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3221 BEACON PKWY STE 100, GRANGER, IN 46530-7196
(574) 647-2930
(574) 647-2935
Mailing address
3245 HEALTH DRIVE, SUITE 100, GRANGER, IN 46530-1380
(574) 647-1840
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT00003199
WA
225XH1200X
Hand Occupational Therapist
Primary
31006709A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300085802
—
IN
Enumeration date
04/01/2013
Last updated
02/07/2024
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