Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1057 | MN |
NPI | 1922113083 |
---|---|
Provider Name | Karen Ann Rezin |
First Address | Tomah, WI 54660-8587 |
Second Address | Tomah, WI 54660-3105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 14/11/2008 |