Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 844-19 | WI |
NPI | 1346533007 |
---|---|
Provider Name | Mrs. Erin E Mccreary |
First Address | Cumberland, WI 54829-9384 |
Second Address | Luck, WI 54853-9066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2011 |
Last Update Date | 27/05/2011 |