Healthcare Provider Details

I. General information

NPI: 1619355054
Provider Name (Legal Business Name): ALISHA WERNER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2015
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 E FLORIDA AVE
APPLETON WI
54911-1325
US

IV. Provider business mailing address

325 E FLORIDA AVE
APPLETON WI
54911-1325
US

V. Phone/Fax

Practice location:
  • Phone: 920-738-4870
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2090-19
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17537-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: