Healthcare Provider Details

I. General information

NPI: 1275557910
Provider Name (Legal Business Name): ELIZABETH ZAHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HIGHLAND AVE COMPLIANCE MAIL CODE-2433
MADISON WI
53792-0001
US

IV. Provider business mailing address

600 HIGHLAND AVE COMPLIANCE MAIL CODE-2433
MADISON WI
53792-0001
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-8410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2638-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: