Individual
ELIZABETH R POMEROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR, CLT-LANA
Contact information
Practice address
200 E TYRANENA PARK RD, LAKE MILLS, WI 53551-9678
(920) 648-8170
(920) 648-8225
Mailing address
104 SANCTUARY CT, JOHNSON CREEK, WI 53038-9664
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4107-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41030400
—
WI
Enumeration date
09/22/2006
Last updated
07/09/2007
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