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Individual

BRIAN M ZAMZOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
N112W17975 MEQUON RD, GERMANTOWN, WI 53022-2425
(262) 532-7680
Mailing address
N112W17975 MEQUON RD, GERMANTOWN, WI 53022-2425
(262) 532-7680

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5375
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100041622
WI
Enumeration date
12/01/2014
Last updated
12/18/2019
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