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General NPI Number Information
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NPI Number | 1346533007
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Entity Type | Individual
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Provider Name | ERIN E MCCREARY PTA
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Gender | Female
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Dates
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Enumeration Date | 05/27/2011
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Last Update Date | 05/27/2011
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Provider Practice Location Address
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Address Line | 210 E PARK AVE
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City | LUCK
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State | WI
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Zip | 54853-9066
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Country | US
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Telephone | 715-472-2164
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Fax |
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Provider Business Mailing Address
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Address Line | 151 260TH AVE
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City | CUMBERLAND
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State | WI
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Zip | 54829-9384
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Country | US
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Telephone | 715-822-3631
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 844-19
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License Number State | WI
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