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NPI Code Detail

MEDICARE: NANCY J PAULSON P.T.

MEDICARE: NANCY J PAULSON P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5810-024WI

General Provider Information

NPI Number : 1184881906
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY J PAULSON P.T.
Provider Business Mailing Address
First Line : 1319 BEASER AVE
Second Line :
City : ASHLAND
State : WI
Zip : 54806-3614
Country : US
Telephone Number : 715-682-3468
Fax Number :
Provider Business Practice Location Address
First Line : 1319 BEASER AVE
Second Line :
City : ASHLAND
State : WI
Zip : 54806-3614
Country : US
Telephone Number : 715-682-3468
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2008
Last Update Date : 05/20/2008

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