Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 1544-026 | WI |
NPI | 1003940727 |
---|---|
Provider Name | Elizabeth Ann Friske |
First Address | Merrill, WI 54452-9413 |
Second Address | Antigo, WI 54409-2710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40722700 | (05) | WI |