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NPI Code Detail

MEDICARE: PATSY L BRILLA

MEDICARE: PATSY L BRILLA
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
1224Z00000XOccupational Therapy Assistant1909-027WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215102801
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATSY L BRILLA
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 : 04/24/2008
Last Update Date : 04/24/2008

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Directions to “ PATSY L BRILLA ” Practice Location

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