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NPI Code Detail

MEDICARE: CATHERINE MARY VAN LAANEN PT

MEDICARE: CATHERINE MARY VAN LAANEN PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist9531-024WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699720060
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE MARY VAN LAANEN PT
Provider Business Mailing Address
First Line : 10412 N BAEHR RD
Second Line :
City : MEQUON
State : WI
Zip : 53092-4472
Country : US
Telephone Number : 262-236-0176
Fax Number : 262-236-0178
Provider Business Practice Location Address
First Line : 10412 N BAEHR RD
Second Line :
City : MEQUON
State : WI
Zip : 53092-4472
Country : US
Telephone Number : 262-236-0176
Fax Number : 262-236-0178
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 12/04/2024

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Directions to “ CATHERINE MARY VAN LAANEN PT” Practice Location

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