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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACKIE CHURCH II

Active

JACKIE CHURCH II is a Occupational Therapist healthcare provider located in EDGERTON, Wisconsin. NPI 1104029362 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · EDGERTON, WI

Registration Details

NPI Number
1104029362
Provider Type
Individual
Gender
Female
NPI Issued
Jun 6, 2007 (19.007947741516 yrs)
Last Updated
Jul 8, 2007
License
783-019 (WI)

Practice Information

Address
313 STOUGHTON RD
EDGERTON, WI, 535341132
Browse WI providers · Browse ZIP 53534
Phone
6088841390
Primary Specialty
Occupational Therapist
225200000X

Other Occupational Therapist Providers in EDGERTON, WI

Name Credential NPI
SHERRY CATACUTAN 1588777585
MS. CHARLENE FAY STIPES PTA 1841357324
SHELLY BUTT 1235347907
BOBBI JO BOGNER II 1578766721
BRETT PODLINSEK 1457821159
MR. EVAN GRAHAM BUHROW 1568182541
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.