Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 933-024 | WI |
NPI | 1083724652 |
---|---|
Provider Name | Sharon Kay Rusch |
First Address | Manitowoc, WI 54220-3712 |
Second Address | Manitowoc, WI 54220-3712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |