Individual
MRS. AMY BETH BROTCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
305 S CLARK ST, MAYVILLE, WI 53050-1488
(920) 387-1370
Mailing address
W3370 W. NEDA RD, HORICON, WI 53032
(920) 387-2237
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2906-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40841000
—
WI
Enumeration date
05/15/2007
Last updated
07/09/2007
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