Healthcare Provider Details

I. General information

NPI: 1720463805
Provider Name (Legal Business Name): ASHLEY WICHMANN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY WOEST DPT

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 BETHEL CIR
WAUNAKEE WI
53597-9589
US

IV. Provider business mailing address

4522 ONYX LN
MADISON WI
53714-2529
US

V. Phone/Fax

Practice location:
  • Phone: 920-609-0981
  • Fax:
Mailing address:
  • Phone: 920-609-0981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13223-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: