Healthcare Provider Details

I. General information

NPI: 1467736801
Provider Name (Legal Business Name): ADDIE L HOLZMANN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADDIE L SEAMAN PT

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 10/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 KELLER AVE N
AMERY WI
54001-1036
US

IV. Provider business mailing address

265 GRIFFIN ST E
AMERY WI
54001-1439
US

V. Phone/Fax

Practice location:
  • Phone: 715-268-1008
  • Fax: 715-268-0111
Mailing address:
  • Phone: 715-268-8000
  • Fax: 715-268-0111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11707
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: