Healthcare Provider Details

I. General information

NPI: 1659340578
Provider Name (Legal Business Name): TERESA L RAUSCHER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RANDOLPH RD
JANESVILLE WI
53546-4015
US

IV. Provider business mailing address

435 ELM ST
MILTON WI
53563-1206
US

V. Phone/Fax

Practice location:
  • Phone: 608-743-7544
  • Fax:
Mailing address:
  • Phone: 680-868-6179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number5217024
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: