Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 13103-24 | WI |
NPI | 1003282088 |
---|---|
Provider Name | Hannah Vogt |
First Address | Richland Center, WI 53581-1900 |
Second Address | Richland Center, WI 53581-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2015 |
Last Update Date | 13/08/2015 |