Individual ProviderMary J WollenburgOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address199 Home Rd, Juneau, WI 53039-1401(920) 386-3500PECOS EnrollmentBased on the most recent information from CMS, provider Mary J Wollenburg does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1093806549Provider TypeIndividualFull NameWollenburg, Mary JTitleMs.CredentialOTRGenderFemaleSole ProprietorNoEnumeration Date9/28/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address199 Home Rd, Juneau, WI 53039-1401Phone(920) 386-3500Fax(920) 386-3812Mailing LocationMailing Address199 Home Rd, Juneau, WI 53039-1401Phone(920) 386-3500Fax(920) 386-3812Provider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense476-026Wisconsin