Jenelle Boyer, OTR/L, CLT

Individual provider Active NPI Occupational Therapist · Viroqua, WI

NPI 1124412499 · NPPES record last updated Mar 25, 2015

Key facts

NPI
1124412499
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
3963-26 (WI)
Practice address
407 S Main St
Suite 302
Viroqua, WI 54665-2100
Phone
(608) 637-4385
NPI assigned
Mar 25, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3963-26WIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3963-26 WI Yes

Addresses

Primary practice location

407 S Main St
Suite 302
Viroqua, WI 54665-2100

Mailing address

407 S Main St
Suite 302
Viroqua, WI 54665-2100
Phone (608) 637-4385

Other providers in Viroqua, WI

All providers in Viroqua, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.