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NPI Code Detail

MEDICARE: MYA ROGNSTAD DPT

MEDICARE: MYA ROGNSTAD DPT
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 Therapist9574-024WI

General Provider Information

NPI Number : 1851496186
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYA ROGNSTAD DPT
Provider Business Mailing Address
First Line : 1353 WINCHESTER PASS
Second Line :
City : VERONA
State : WI
Zip : 53593-2289
Country : US
Telephone Number : 608-513-0163
Fax Number :
Provider Business Practice Location Address
First Line : 700 N MAIN ST
Second Line :
City : VERONA
State : WI
Zip : 53593-1103
Country : US
Telephone Number : 608-845-4313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 04/14/2026

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Directions to “ MYA ROGNSTAD DPT” Practice Location

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