Provider Demographics
NPI:1598970188
Name:OELIG, DENISE MARIE (OT)
Entity Type:Individual
Prefix:MR
First Name:DENISE
Middle Name:MARIE
Last Name:OELIG
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W4956 OSERO LN
Mailing Address - Street 2:
Mailing Address - City:TOMAHAWK
Mailing Address - State:WI
Mailing Address - Zip Code:54487-8305
Mailing Address - Country:US
Mailing Address - Phone:715-453-1419
Mailing Address - Fax:
Practice Address - Street 1:2600 RIB MOUNTAIN DR
Practice Address - Street 2:SUITE 220
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-7148
Practice Address - Country:US
Practice Address - Phone:715-843-5300
Practice Address - Fax:715-843-5329
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2051-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI526595Medicare ID - Type Unspecified