Individual
MISS THERESA GURGEL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS, OTR
Contact information
Practice address
1105 WAUPACA ST, FREMONT, WI 54940-9072
(920) 446-3508
Mailing address
PO BOX 225, 1105 WAUPACA STREET, FREMONT, WI 54940-0225
(920) 446-3508
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4392-026
WI
Other
Enumeration date
05/25/2006
Last updated
07/08/2007
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