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SUSAN K NORTH PTA

>> Physical Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1902079361

Individual Registrant:
 SUSAN K NORTH PTA
Gender: F
Sole Proprietor

Location and contact information for practice:
263 CENTER ST  RANDOLPH, WI 53956-1409 US
Tel: 920-326-5691  Fax: --

Contact information for business:
263 CENTER ST  RANDOLPH, WI 53956-1409 US
Tel: 920-326-5691  Fax: --

Registration Information:
NPI: 1902079361
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225200000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapy Assistant
WI497-019

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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