Healthcare Provider Details

I. General information

NPI: 1639895485
Provider Name (Legal Business Name): ABBI OIUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 10/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E BROWN ST
AUGUSTA WI
54722-9346
US

IV. Provider business mailing address

12159 WILLOW LN
OSSEO WI
54758-7706
US

V. Phone/Fax

Practice location:
  • Phone: 715-286-2266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: