Individual
MR. MICHAEL WILLIAM WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
98 SHERRY AVE, PARK FALLS, WI 54552-1467
(715) 762-7470
Mailing address
PO BOX 310, PARK FALLS, WI 54552-0310
(715) 762-7470
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3104-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40817400
—
WI
Enumeration date
04/23/2008
Last updated
04/23/2008
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