Individual
JEAN ELIZABETH GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
700 CLARK ST, LODI, WI 53555-1010
(608) 592-3241
Mailing address
700 CLARK ST, LODI, WI 53555-1010
(608) 592-3241
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2806-26
WI
Other
Enumeration date
11/17/2008
Last updated
11/17/2008
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