Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 2383-24 | WI |
NPI | 1215204680 |
---|---|
Provider Name | Mrs. Karen W Hirst |
First Address | Madison, WI 53714-3009 |
Second Address | Milwaukee, WI 53227-2466 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2011 |
Last Update Date | 29/11/2011 |