| Doctor Name: | THERESA MARIE PRUCHA |
| NPI Number: | 1285761023 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | O.T.R. C.H.T. |
| License Number: | 1583-026 |
| Business Practice Address: | 5000 Memorial Dr Two Rivers, WI - 542413900 |
| Business Phone Number: | 9207945176 |
| Business Fax Number: | |
| Mailing Address: | 716 Steiners Corners Rd, TWO RIVERS |
| State: | WI |
| Postal Code: | 542419733 |
| Phone Number: | 9201554105 |
| Fax Number: | |
| NPI Enumeration Date: | 02/28/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225XH1200X |
| License Number: | 1583-026 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Occupational Therapist |
| Taxonomy Specialization: | Hand |
| Taxonomy Definition: | |