Healthcare Provider Details

I. General information

NPI: 1902943210
Provider Name (Legal Business Name): SHARON-DIANE WESSLUND SEMLING PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N 32ND AVE
WAUSAU WI
54401-4701
US

IV. Provider business mailing address

1830 CRESTVIEW DR
WAUSAU WI
54403-8107
US

V. Phone/Fax

Practice location:
  • Phone: 715-847-2600
  • Fax:
Mailing address:
  • Phone: 715-675-9925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number4111-024
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4111-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: