Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1023558350 |
---|---|
Provider Name | William Zuengler |
First Address | Fond Du Lac, WI 54935-3362 |
Second Address | Fond Du Lac, WI 54935-3362 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2017 |
Last Update Date | 06/03/2017 |