Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2020025989 | MO |
N | 2251C2600X | Cardiopulmonary | ||
N | 2251E1200X | Ergonomics | ||
N | 225XE1200X | Ergonomics | ||
N | 2251E1300X | Electrophysiology, Clinical | ||
N | 2251G0304X | Physical Therapist - Geriatrics | ||
N | 2251H1200X | Hand | ||
N | 2251H1300X | Human Factors | ||
N | 225XH1300X | Human Factors | ||
N | 2251N0400X | Physical Therapist - Neurology | ||
N | 2251S0007X | Physical Therapist - Sports | ||
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1760079958 |
---|---|
Provider Name | Michael Alexander Wilshusen |
First Address | Leslie, MO 63056-1101 |
Second Address | Owensville, MO 65066-1677 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2020 |
Last Update Date | 22/12/2020 |