Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2804-19 | WI |
NPI | 1003383894 |
---|---|
Provider Name | Nevada Leigh Schlegel |
First Address | Chippewa Falls, WI 54729-2656 |
Second Address | Chippewa Falls, WI 54729-2656 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2018 |
Last Update Date | 30/10/2018 |