Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1503-24 | WI |
NPI | 1194185330 |
---|---|
Provider Name | Lauren Pollpeter |
First Address | Colgate, WI 53017-9501 |
Second Address | Colgate, WI 53017-9501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2016 |
Last Update Date | 01/03/2016 |