Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | WI |
NPI | 1003041260 |
---|---|
Provider Name | Hannah G. Eastman |
First Address | Appleton, WI 54913-8018 |
Second Address | Sturgeon Bay, WI 54235-1318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2009 |
Last Update Date | 18/05/2009 |