Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 2293-024 | WI |
NPI | 1043392947 |
---|---|
Provider Name | Ms. Cheryl Jo Ginther |
First Address | Oregon, WI 53575-3017 |
Second Address | Oregon, WI 53575-3017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40242600 | (05) | WI |