Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 4040-024 | WI |
NPI | 1053479873 |
---|---|
Provider Name | Mary J Schlimgen |
First Address | Madison, WI 53715-1507 |
Second Address | Middleton, WI 53562-2211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 08/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
36113300 | (05) | WI |